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Billing code 26686: Hand dislocationMedicare rate & RVUs

Report open operative treatment of multiple carpometacarpal dislocations when the surgeon exposes and reduces the affected hand joints, with fixation when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities67 Medicare services in 2024

Medicare pays $592.53 for 26686 nationally in a facility.

Medicare rate · 26686

Hand dislocation

Swap in your local Medicare rate.

Work RVUs
7.97
Total RVUs
17.74
Global days
090

National rate · 2026

$592.53

Facility setting, before claim adjustments.

See every locality for 26686 → · 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
  1. Medicare rate
  2. What 26686 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26686 covers

This service covers open treatment of multiple carpometacarpal (CMC) joint dislocations in the hand. An orthopedic or hand surgeon exposes the involved joints, restores alignment, and may stabilize them with internal fixation. It is generally performed in a facility operating room for injuries requiring open reduction, such as multiple unstable CMC dislocations. The code distinguishes treatment of multiple joints from open treatment of a single CMC dislocation and from closed or percutaneous approaches.

Report the code when the operative record supports open treatment of multiple CMC dislocations; document the affected joints, approach, reduction, and any fixation. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 services may be paid; 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 26686 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

26686 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$534.30
Alaska*Unavailable$717.83
ArizonaUnavailable$576.04
ArkansasUnavailable$527.10
AtlantaUnavailable$608.99
AustinUnavailable$602.28
BakersfieldUnavailable$601.43
Baltimore/Surr. CntysUnavailable$629.87
BeaumontUnavailable$564.24
BrazoriaUnavailable$579.81

26686 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
26686 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 26686 rate is calculated

Each of 26686’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 · 26686

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.97Practice expense 8.08Malpractice 1.69

17.7400 adjusted RVUs×$33.4009 conversion factor=$592.53

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 26686

26686 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26686

Hand dislocation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26686

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26686 without 51 · national facility

$592.53

Hand dislocation

26686-51 · Second procedure: 50%

$296.27

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%).

When to use modifier 51

26686 compared with similar codes

Compare codes

26686 vs 26685 vs 26676 vs 26675 vs 26641: national Medicare rates

Swap in your local Medicare rate.

  • 26686
    Hand dislocation · 7.97 wRVU
    —
  • 26685
    Hand dislocation · 6.89 wRVU
    —
  • 26676
    Hand dislocation · 5.6 wRVU
    —
  • 26675
    Hand dislocation · 4.71 wRVU
    $515.38
  • 26641
    Thumb dislocation · 4.03 wRVU
    $469.28

How to choose

26685Hand dislocation
Both describe open treatment of CMC dislocations. Choose 26685 for a single dislocation and this code for multiple dislocations.
26676Hand dislocation
26676 describes percutaneous skeletal fixation of a single CMC dislocation. This code is for open treatment of multiple dislocations.
26675Hand dislocation
26675 is closed treatment with manipulation. This code is for open treatment of multiple CMC dislocations.
26641Thumb dislocation
26641 addresses a thumb CMC dislocation. This code covers open treatment of multiple CMC dislocations elsewhere in the hand.

Codes related to 26686

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

Codes related to 26686
CodeHow it relatesNational office range
Same family
26685Hand dislocationOpen treatment of a single CMC dislocation; this code covers multiple dislocations.No office rate
Used instead
26676Hand dislocationPercutaneous skeletal fixation for a single CMC dislocation rather than open treatment of multiple joints.No office rate
26675Hand dislocationClosed treatment with manipulation rather than open operative treatment.$453.17–$660.08
26670Hand dislocationClosed treatment without manipulation rather than open operative treatment.$376.94–$552.48
26641Thumb dislocationTreatment of a thumb CMC dislocation, not multiple non-thumb CMC dislocations.$412.21–$605.99

26686 billing questions

When should this code be chosen instead of 26685?

Use this code for open treatment of multiple CMC dislocations. Code 26685 is for open treatment of a single CMC dislocation.

How does this differ from closed treatment codes?

This code describes open operative treatment. Codes 26670 and 26675 describe closed treatment, without and with manipulation, respectively.

Does internal fixation have to be performed?

No. Fixation may be used, but the code covers open treatment whether or not internal fixation is performed.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted.

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
RVUs for 26686PPRRVU2026_Oct_nonQPP.csv, line 2,671 (RVU26D)

Open CMS sourceHow we calculate rates

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