Billing code 26685: Hand dislocationMedicare rate & RVUs

Medicare pays $535.42 for 26685 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 26685 covers

This code describes open treatment of a carpometacarpal (CMC) dislocation in a metacarpal other than the thumb. A common setting is operative care for an unstable or displaced ring- or small-finger CMC injury, including injuries after an axial load to the hand. An orthopedic or hand surgeon exposes the joint to reduce the dislocation; the operative approach and any stabilization should be documented. Thumb CMC dislocations are coded separately.

Choose this open-treatment code based on the operative service, not simply the diagnosis of dislocation. The record should identify the affected joint or joints, the dislocation, and the open reduction performed; document fixation when used to distinguish the applicable sibling code. The 90-day global period includes 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. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is 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 26685 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

26685 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 26685 rate is calculated

Each of 26685’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.

Payment rules and modifiers for 26685

26685 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

26685 compared with similar codes

How to choose

26675Hand dislocation

26675 is closed treatment with manipulation. Use 26685 for open treatment of the non-thumb CMC dislocation.

26676Hand dislocation

26676 describes percutaneous skeletal fixation with manipulation, rather than open treatment.

26686Hand dislocation

Both codes concern open treatment of a non-thumb CMC dislocation. Review the operative service and fixation details to select the applicable code.

26641Thumb dislocation

26641 applies to a thumb CMC dislocation; 26685 applies to a CMC dislocation in another metacarpal ray.

Codes related to 26685

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates