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Billing code 26715: Knuckle dislocationMedicare rate & RVUs

Open reduction of a single metacarpophalangeal joint dislocation, typically when closed reduction fails or soft tissue blocks alignment.

CMS RVU26DEffective Oct 1, 2026109 payment localities253 Medicare services in 2024

Medicare pays $545.10 for 26715 nationally in a facility.

Medicare rate · 26715

Knuckle dislocation

Swap in your local Medicare rate.

Work RVUs
6.85
Total RVUs
16.32
Global days
090

National rate · 2026

$545.10

Facility setting, before claim adjustments.

See every locality for 26715 → · 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 26715 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 26715 covers

A hand or orthopedic surgeon uses an open approach to restore alignment of a dislocated metacarpophalangeal joint. This may be needed when a closed reduction cannot restore the joint, such as when soft tissue is trapped between the joint surfaces, or when the surgeon determines open treatment is necessary. The procedure is commonly performed in an operating room for a traumatic knuckle dislocation.

Report this code for open treatment of one MCP joint dislocation; distinguish it from closed reduction and percutaneous fixation. The operative note should identify the joint and digit, describe the open reduction, and document any fixation. Internal fixation, when performed, is included. CMS assigns a 90-day global period, including the day-before preoperative visit and 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. Bilateral adjustment is not appropriate. 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 26715 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

26715 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$491.94
Alaska*Unavailable$657.40
ArizonaUnavailable$530.32
ArkansasUnavailable$485.34
AtlantaUnavailable$559.01
AustinUnavailable$556.32
BakersfieldUnavailable$558.34
Baltimore/Surr. CntysUnavailable$579.08
BeaumontUnavailable$517.47
BrazoriaUnavailable$534.78

26715 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
26715 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 26715 rate is calculated

Each of 26715’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 · 26715

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.85Practice expense 8.15Malpractice 1.32

16.3200 adjusted RVUs×$33.4009 conversion factor=$545.10

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

Payment rules and modifiers for 26715

26715 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26715

Knuckle 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)0Not paid without supporting documentation.
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 · 26715

Knuckle 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

26715 without 51 · national facility

$545.10

Knuckle dislocation

26715-51 · Second procedure: 50%

$272.55

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

26715 compared with similar codes

Compare codes

26715 vs 26700 vs 26705 vs 26706 vs 26785: national Medicare rates

Swap in your local Medicare rate.

  • 26715
    Knuckle dislocation · 6.85 wRVU
    —
  • 26700
    MCP dislocation · 3.73 wRVU
    $406.82
  • 26705
    Knuckle reduction · 4.27 wRVU
    $488.66
  • 26706
    Knuckle dislocation · 5.18 wRVU
    —
  • 26785
    Finger dislocation · 6.44 wRVU
    —

How to choose

26700MCP dislocation
26700 is closed treatment of an MCP dislocation without manipulation. Use 26715 when the surgeon treats the joint through an open approach.
26705Knuckle reduction
26705 covers closed treatment with manipulation requiring anesthesia; 26715 covers open treatment of the MCP dislocation.
26706Knuckle dislocation
26706 uses percutaneous skeletal fixation. 26715 is for open treatment, with internal fixation included when performed.
26785Finger dislocation
26785 is open treatment of a dislocation at a finger interphalangeal joint. 26715 is for an MCP joint.

Codes related to 26715

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

Codes related to 26715
CodeHow it relatesNational office range
Same family
26700MCP dislocationClosed treatment of an MCP dislocation without manipulation.$357.49–$520.16
26705Knuckle reductionClosed treatment of an MCP dislocation with manipulation requiring anesthesia.$429.41–$629.75
26706Knuckle dislocationPercutaneous skeletal fixation for an MCP dislocation.No office rate
Used instead
26770Finger dislocationClosed treatment of a finger dislocation at an interphalangeal joint.$317.26–$466.69
26785Finger dislocationOpen treatment of an interphalangeal joint dislocation rather than an MCP dislocation.No office rate

26715 billing questions

How does this differ from 26705?

26705 is for closed treatment with manipulation requiring anesthesia. Report 26715 when the dislocation is treated through an open approach.

Can internal fixation be reported separately?

No. Internal fixation, when performed as part of the open treatment, is included in 26715.

When is 26706 a better fit?

26706 describes percutaneous skeletal fixation of an MCP dislocation. Use 26715 for open treatment.

What documentation supports 26715?

Document the affected MCP joint and digit, the dislocation, the open approach and reduction, and any fixation performed.

Can modifier 50 be used for dislocations on both hands?

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

What is included in the global period?

The 90-day global period includes the day-before preoperative visit and related postoperative care.

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 26715PPRRVU2026_Oct_nonQPP.csv, line 2,675 (RVU26D)

Open CMS sourceHow we calculate rates

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