Billing code 26670: Hand dislocationMedicare rate & RVUs
Reports closed management of a carpometacarpal dislocation outside the thumb when the provider treats the injury without manipulating the joint.
Medicare pays $429.87 for 26670 nationally in the office and $357.39 in a hospital or facility. Local office rates run $376.94–$552.48.
Medicare rate · 26670
Hand dislocation
- Work RVUs
- 3.73
- Total RVUs
- 12.87
- Global days
- 090
National rate · 2026
$429.87
Office setting, before claim adjustments.
See every locality for 26670 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 26670 covers
This code covers closed management of a carpometacarpal joint dislocation in the hand, excluding the thumb, when the provider does not manipulate the joint. These injuries may involve the bases of the metacarpals, including the ring- or small-finger side of the hand. Orthopedic or hand surgeons commonly provide this treatment; an emergency physician may also manage the injury when the documented service meets the code’s scope.
Select this code when the record identifies a non-thumb carpometacarpal dislocation and supports treatment without manipulation. Documentation should specify the injured joint, the treatment performed, and why manipulation was not part of the service. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 26670 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$376.94 to $552.48
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $382.83 | $319.41 |
| Alaska* | $497.24 | $420.05 |
| Arizona | $417.16 | $346.93 |
| Arkansas | $376.94 | $314.68 |
| Atlanta | $440.44 | $366.80 |
| Austin | $442.88 | $366.20 |
| Bakersfield | $447.56 | $368.12 |
| Baltimore/Surr. Cntys | $458.86 | $381.09 |
| Beaumont | $402.94 | $336.98 |
| Brazoria | $422.06 | $350.23 |
| Chicago | $469.32 | $396.48 |
| Chico | $445.21 | $365.77 |
| Colorado | $442.77 | $365.66 |
| Connecticut | $459.69 | $381.63 |
| Dallas | $425.81 | $353.62 |
| Dc + Md/Va Suburbs | $489.07 | $403.69 |
| Delaware | $424.27 | $352.66 |
| Detroit | $439.90 | $369.95 |
| East St. Louis | $436.87 | $370.19 |
| El Centro | $445.35 | $365.91 |
| Fort Lauderdale | $456.67 | $383.25 |
| Fort Worth | $423.41 | $351.95 |
| Fresno | $445.21 | $365.77 |
| Galveston | $423.99 | $352.02 |
| Hanford-Corcoran | $445.21 | $365.77 |
| Hawaii, Guam | $455.67 | $373.26 |
| Houston | $439.73 | $367.76 |
| Idaho | $392.61 | $325.93 |
| Indiana | $394.92 | $327.73 |
| Iowa | $389.04 | $322.72 |
| Kansas | $389.07 | $323.55 |
| Kentucky | $396.73 | $332.30 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $475.94 | $390.19 |
| Madera | $445.21 | $365.77 |
| Manhattan | $499.48 | $415.26 |
| Merced | $445.21 | $365.77 |
| Metropolitan Boston | $485.47 | $398.93 |
| Metropolitan Kansas City | $412.34 | $344.28 |
| Metropolitan Philadelphia | $448.99 | $373.54 |
| Metropolitan St. Louis | $416.65 | $347.65 |
| Miami | $485.13 | $409.68 |
| Minnesota | $417.67 | $343.09 |
| Mississippi | $383.93 | $321.53 |
| Modesto | $445.21 | $365.77 |
| Montana** | $429.81 | $357.33 |
| Napa | $511.53 | $416.00 |
| Nebraska | $390.71 | $323.81 |
| Nevada** | $425.35 | $352.80 |
| New Hampshire | $437.62 | $362.17 |
| New Mexico | $412.69 | $346.22 |
| New Orleans | $417.46 | $349.26 |
| North Carolina | $400.97 | $333.35 |
| North Dakota** | $412.81 | $340.33 |
| Northern Nj | $483.92 | $399.84 |
| Nyc Suburbs/Long Island | $514.73 | $428.55 |
| Ohio | $406.04 | $339.86 |
| Oklahoma | $393.87 | $329.15 |
| Oxnard-Thousand Oaks-Ventura | $472.86 | $387.19 |
| Portland | $455.21 | $374.68 |
| Poughkpsie/N Nyc Suburbs | $467.78 | $388.42 |
| Puerto Rico | $432.48 | $359.20 |
| Queens | $500.87 | $415.20 |
| Redding | $445.21 | $365.77 |
| Rest Of California | $445.21 | $365.77 |
| Rest Of Florida | $432.15 | $362.86 |
| Rest Of Georgia | $405.52 | $340.86 |
| Rest Of Illinois | $421.98 | $355.81 |
| Rest Of Louisiana | $396.86 | $332.71 |
| Rest Of Maine | $396.89 | $330.21 |
| Rest Of Maryland | $432.08 | $358.73 |
| Rest Of Massachusetts | $440.69 | $364.37 |
| Rest Of Michigan | $409.51 | $343.34 |
| Rest Of Missouri | $390.96 | $328.48 |
| Rest Of New Jersey | $463.08 | $383.93 |
| Rest Of New York | $407.51 | $338.65 |
| Rest Of Oregon | $420.23 | $348.04 |
| Rest Of Pennsylvania | $405.61 | $339.08 |
| Rest Of Texas | $412.98 | $344.20 |
| Rest Of Washington | $439.28 | $362.96 |
| Rhode Island | $438.26 | $363.39 |
| Riverside-San Bernardino-Ontario | $454.44 | $375.00 |
| Sacramento-Roseville-Folsom | $466.11 | $381.81 |
| Salinas | $464.38 | $380.37 |
| San Diego-Chula Vista-Carlsbad | $474.66 | $387.97 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $539.55 | $437.36 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $538.58 | $436.38 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $552.48 | $447.97 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $548.49 | $443.98 |
| San Luis Obispo-Paso Robles | $457.10 | $374.55 |
| Santa Cruz-Watsonville | $478.62 | $390.55 |
| Santa Maria-Santa Barbara | $465.94 | $381.43 |
| Santa Rosa-Petaluma | $483.33 | $394.33 |
| Seattle (King Cnty) | $493.62 | $404.69 |
| South Carolina | $404.54 | $337.57 |
| South Dakota** | $410.80 | $338.32 |
| Southern Maine | $416.78 | $344.95 |
| Stockton | $445.21 | $365.77 |
| Suburban Chicago | $460.38 | $385.95 |
| Tennessee | $391.40 | $325.52 |
| Utah | $410.35 | $342.21 |
| Vallejo | $510.12 | $414.60 |
| Vermont | $412.91 | $341.16 |
| Virgin Islands | $432.48 | $359.20 |
| Virginia | $416.72 | $345.48 |
| Visalia | $445.21 | $365.77 |
| West Virginia | $406.02 | $343.04 |
| Wisconsin | $398.38 | $328.94 |
| Wyoming** | $422.40 | $349.92 |
| Yuba City | $445.21 | $365.77 |
26670 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$376.94
$498.85
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $497.24 | 1 |
| AL | $382.83 | 1 |
| AR | $376.94 | 1 |
| AZ | $417.16 | 1 |
| CA | $445.21–$552.48 | 29 |
| CO | $442.77 | 1 |
| CT | $459.69 | 1 |
| DC | $489.07 | 1 |
| DE | $424.27 | 1 |
| FL | $432.15–$485.13 | 3 |
| GA | $405.52–$440.44 | 2 |
| GU | $455.67 | 1 |
| HI | $455.67 | 1 |
| IA | $389.04 | 1 |
| ID | $392.61 | 1 |
| IL | $421.98–$469.32 | 4 |
| IN | $394.92 | 1 |
| KS | $389.07 | 1 |
| KY | $396.73 | 1 |
| LA | $396.86–$417.46 | 2 |
| MA | $440.69–$485.47 | 2 |
| MD | $432.08–$489.07 | 3 |
| ME | $396.89–$416.78 | 2 |
| MI | $409.51–$439.90 | 2 |
| MN | $417.67 | 1 |
| MO | $390.96–$416.65 | 3 |
| MS | $383.93 | 1 |
| MT | $429.81 | 1 |
| NC | $400.97 | 1 |
| ND | $412.81 | 1 |
| NE | $390.71 | 1 |
| NH | $437.62 | 1 |
| NJ | $463.08–$483.92 | 2 |
| NM | $412.69 | 1 |
| NV | $425.35 | 1 |
| NY | $407.51–$514.73 | 5 |
| OH | $406.04 | 1 |
| OK | $393.87 | 1 |
| OR | $420.23–$455.21 | 2 |
| PA | $405.61–$448.99 | 2 |
| PR | $432.48 | 1 |
| RI | $438.26 | 1 |
| SC | $404.54 | 1 |
| SD | $410.80 | 1 |
| TN | $391.40 | 1 |
| TX | $402.94–$442.88 | 8 |
| UT | $410.35 | 1 |
| VA | $416.72–$489.07 | 2 |
| VI | $432.48 | 1 |
| VT | $412.91 | 1 |
| WA | $439.28–$493.62 | 2 |
| WI | $398.38 | 1 |
| WV | $406.02 | 1 |
| WY | $422.40 | 1 |
How the 26670 rate is calculated
Each of 26670’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 26670
RVUs × geographic indexes × conversion factor
Work3.73
3.73 RVUs× 1.000 GPCI
Practice expense8.28
8.28 RVUs× 1.000 GPCI
Malpractice0.86
0.86 RVUs× 1.000 GPCI
Adjusted RVUs
12.8700
Conversion factor
$33.4009
Medicare rate
$429.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26670
26670 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26670
Hand dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26670
Hand dislocation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26670 without 51 · national office
$429.87
Hand dislocation
26670-51 · Second procedure: 50%
$214.94
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26670 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26675Hand dislocation
- Both address closed treatment of a non-thumb carpometacarpal dislocation. Choose 26670 when treatment is without manipulation and 26675 when manipulation is performed.
- 26641Thumb dislocation
- 26641 addresses a thumb carpometacarpal dislocation without manipulation; 26670 is for a dislocation outside the thumb.
- 26685Hand dislocation
- 26685 is for open treatment of a non-thumb carpometacarpal dislocation. This code describes closed treatment without manipulation.
- 26600Metacarpal fracture care
- 26600 is for closed treatment of a metacarpal fracture without manipulation. Use 26670 for a carpometacarpal dislocation, not a fracture.
26670 billing questions
How does this differ from 26675?
26670 is for closed treatment without manipulation. Use 26675 when manipulation is performed.
Can this code be used for a thumb carpometacarpal dislocation?
No. This code is for a carpometacarpal dislocation outside the thumb; 26641 is the corresponding closed-treatment code for a thumb dislocation without manipulation.
Is modifier 50 appropriate when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when the medical necessity is documented.
Can it be reported with another procedure performed in the same session?
Yes, when both procedures are separately reportable. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to the reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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