Billing code 26725: Finger fracture treatmentMedicare rate & RVUs
Closed treatment of a proximal or middle phalanx shaft fracture with manipulation, reported for each finger or thumb fracture treated.
Medicare pays $395.80 for 26725 nationally in the office and $321.98 in a hospital or facility. Local office rates run $347.69–$511.36.
Medicare rate · 26725
Finger fracture treatment
Swap in your local Medicare rate.
- Work RVUs
- 3.39
- Total RVUs
- 11.85
- Global days
- 090
National rate · 2026
$395.80
Office setting, before claim adjustments.
See every locality for 26725 → · 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 26725 covers
This service is for a shaft fracture of the proximal or middle phalanx of a finger or thumb when the clinician manipulates the fracture to improve alignment without surgically exposing it. An orthopedic or hand surgeon commonly performs the reduction in an office, emergency department, or operating room, then immobilizes the digit with an appropriate splint or cast. The code is reported for each fracture treated.
Documentation should identify the digit and phalanx, establish that the fracture involves the shaft, and support the need for and performance of manipulation. This code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 26725 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
$347.69 to $511.36
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $353.05 | $288.46 |
| Alaska* | $458.42 | $379.81 |
| Arizona | $384.32 | $312.80 |
| Arkansas | $347.69 | $284.28 |
| Atlanta | $405.11 | $330.11 |
| Austin | $408.28 | $330.18 |
| Bakersfield | $413.37 | $332.46 |
| Baltimore/Surr. Cntys | $422.18 | $342.98 |
| Beaumont | $370.83 | $303.65 |
| Brazoria | $389.09 | $315.94 |
| Chicago | $429.03 | $354.84 |
| Chico | $411.39 | $330.48 |
| Colorado | $408.44 | $329.90 |
| Connecticut | $423.02 | $343.52 |
| Dallas | $392.37 | $318.85 |
| Dc + Md/Va Suburbs | $450.65 | $363.69 |
| Delaware | $390.84 | $317.91 |
| Detroit | $403.25 | $332.02 |
| East St. Louis | $399.50 | $331.59 |
| El Centro | $411.51 | $330.60 |
| Fort Lauderdale | $418.59 | $343.82 |
| Fort Worth | $390.10 | $317.32 |
| Fresno | $411.39 | $330.48 |
| Galveston | $390.76 | $317.46 |
| Hanford-Corcoran | $411.39 | $330.48 |
| Hawaii, Guam | $421.09 | $337.17 |
| Houston | $403.94 | $330.64 |
| Idaho | $362.45 | $294.53 |
| Indiana | $364.57 | $296.14 |
| Iowa | $359.32 | $291.78 |
| Kansas | $359.05 | $292.32 |
| Kentucky | $365.06 | $299.44 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $439.67 | $352.35 |
| Madera | $411.39 | $330.48 |
| Manhattan | $459.02 | $373.25 |
| Merced | $411.39 | $330.48 |
| Metropolitan Boston | $447.95 | $359.81 |
| Metropolitan Kansas City | $379.48 | $310.16 |
| Metropolitan Philadelphia | $413.08 | $336.24 |
| Metropolitan St. Louis | $383.44 | $313.17 |
| Miami | $443.17 | $366.33 |
| Minnesota | $386.37 | $310.41 |
| Mississippi | $353.59 | $290.03 |
| Modesto | $411.39 | $330.48 |
| Montana** | $395.75 | $321.94 |
| Napa | $473.31 | $376.02 |
| Nebraska | $360.94 | $292.80 |
| Nevada** | $392.04 | $318.15 |
| New Hampshire | $403.39 | $326.55 |
| New Mexico | $379.18 | $311.49 |
| New Orleans | $383.82 | $314.36 |
| North Carolina | $369.80 | $300.93 |
| North Dakota** | $381.52 | $307.70 |
| Northern Nj | $445.93 | $360.31 |
| Nyc Suburbs/Long Island | $472.52 | $384.75 |
| Ohio | $373.50 | $306.11 |
| Oklahoma | $362.78 | $296.86 |
| Oxnard-Thousand Oaks-Ventura | $436.96 | $349.71 |
| Portland | $420.15 | $338.14 |
| Poughkpsie/N Nyc Suburbs | $430.51 | $349.68 |
| Puerto Rico | $398.28 | $323.66 |
| Queens | $460.73 | $373.48 |
| Redding | $411.39 | $330.48 |
| Rest Of California | $411.39 | $330.48 |
| Rest Of Florida | $396.52 | $325.95 |
| Rest Of Georgia | $372.50 | $306.65 |
| Rest Of Illinois | $386.85 | $319.45 |
| Rest Of Louisiana | $365.06 | $299.73 |
| Rest Of Maine | $366.03 | $298.12 |
| Rest Of Maryland | $398.06 | $323.36 |
| Rest Of Massachusetts | $406.43 | $328.70 |
| Rest Of Michigan | $376.41 | $309.02 |
| Rest Of Missouri | $359.50 | $295.87 |
| Rest Of New Jersey | $426.45 | $345.84 |
| Rest Of New York | $375.73 | $305.61 |
| Rest Of Oregon | $387.62 | $314.10 |
| Rest Of Pennsylvania | $373.28 | $305.52 |
| Rest Of Texas | $380.28 | $310.23 |
| Rest Of Washington | $405.23 | $327.50 |
| Rhode Island | $403.89 | $327.63 |
| Riverside-San Bernardino-Ontario | $419.12 | $338.22 |
| Sacramento-Roseville-Folsom | $430.86 | $345.01 |
| Salinas | $429.26 | $343.70 |
| San Diego-Chula Vista-Carlsbad | $438.85 | $350.57 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $499.54 | $395.46 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $498.72 | $394.64 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $511.36 | $404.92 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $508.02 | $401.58 |
| San Luis Obispo-Paso Robles | $422.50 | $338.43 |
| Santa Cruz-Watsonville | $442.60 | $352.92 |
| Santa Maria-Santa Barbara | $430.73 | $344.66 |
| Santa Rosa-Petaluma | $446.98 | $356.34 |
| Seattle (King Cnty) | $455.75 | $365.17 |
| South Carolina | $372.55 | $304.34 |
| South Dakota** | $379.83 | $306.02 |
| Southern Maine | $384.60 | $311.45 |
| Stockton | $411.39 | $330.48 |
| Suburban Chicago | $422.14 | $346.33 |
| Tennessee | $361.14 | $294.04 |
| Utah | $377.84 | $308.45 |
| Vallejo | $472.13 | $374.84 |
| Vermont | $381.34 | $308.26 |
| Virgin Islands | $398.28 | $323.66 |
| Virginia | $384.34 | $311.77 |
| Visalia | $411.39 | $330.48 |
| West Virginia | $372.30 | $308.15 |
| Wisconsin | $368.30 | $297.59 |
| Wyoming** | $389.55 | $315.73 |
| Yuba City | $411.39 | $330.48 |
26725 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.
$347.69
$461.38
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 | $458.42 | 1 |
| AL | $353.05 | 1 |
| AR | $347.69 | 1 |
| AZ | $384.32 | 1 |
| CA | $411.39–$511.36 | 29 |
| CO | $408.44 | 1 |
| CT | $423.02 | 1 |
| DC | $450.65 | 1 |
| DE | $390.84 | 1 |
| FL | $396.52–$443.17 | 3 |
| GA | $372.50–$405.11 | 2 |
| GU | $421.09 | 1 |
| HI | $421.09 | 1 |
| IA | $359.32 | 1 |
| ID | $362.45 | 1 |
| IL | $386.85–$429.03 | 4 |
| IN | $364.57 | 1 |
| KS | $359.05 | 1 |
| KY | $365.06 | 1 |
| LA | $365.06–$383.82 | 2 |
| MA | $406.43–$447.95 | 2 |
| MD | $398.06–$450.65 | 3 |
| ME | $366.03–$384.60 | 2 |
| MI | $376.41–$403.25 | 2 |
| MN | $386.37 | 1 |
| MO | $359.50–$383.44 | 3 |
| MS | $353.59 | 1 |
| MT | $395.75 | 1 |
| NC | $369.80 | 1 |
| ND | $381.52 | 1 |
| NE | $360.94 | 1 |
| NH | $403.39 | 1 |
| NJ | $426.45–$445.93 | 2 |
| NM | $379.18 | 1 |
| NV | $392.04 | 1 |
| NY | $375.73–$472.52 | 5 |
| OH | $373.50 | 1 |
| OK | $362.78 | 1 |
| OR | $387.62–$420.15 | 2 |
| PA | $373.28–$413.08 | 2 |
| PR | $398.28 | 1 |
| RI | $403.89 | 1 |
| SC | $372.55 | 1 |
| SD | $379.83 | 1 |
| TN | $361.14 | 1 |
| TX | $370.83–$408.28 | 8 |
| UT | $377.84 | 1 |
| VA | $384.34–$450.65 | 2 |
| VI | $398.28 | 1 |
| VT | $381.34 | 1 |
| WA | $405.23–$455.75 | 2 |
| WI | $368.30 | 1 |
| WV | $372.30 | 1 |
| WY | $389.55 | 1 |
How the 26725 rate is calculated
Each of 26725’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 · 26725
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.39Practice expense 7.74Malpractice 0.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26725
26725 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26725
Finger fracture treatment
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 26725
Finger fracture treatment
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
26725 without 51 · national office
$395.80
Finger fracture treatment
26725-51 · Second procedure: 50%
$197.90
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%).
26725 compared with similar codes
Compare codes
26725 vs 26720 vs 26727 vs 26735 vs 26740: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26720Finger fracture care
- Use 26720 when a proximal or middle phalanx shaft fracture is treated without manipulation. This code requires manipulation.
- 26727Finger fracture care
- 26727 includes skeletal traction with manipulation for a proximal or middle phalanx shaft fracture; this code describes manipulation without that traction.
- 26735Finger fracture repair
- 26735 is for open treatment of a proximal or middle phalanx shaft fracture. This code is for closed treatment with manipulation.
- 26740Finger fracture
- 26740 concerns a fracture involving a metacarpophalangeal or interphalangeal joint. This code is for a proximal or middle phalanx shaft fracture.
26725 billing questions
How does this differ from 26720?
26725 is for a proximal or middle phalanx shaft fracture that is manipulated to improve alignment. Use 26720 when the fracture is treated without manipulation.
When would 26727 be more appropriate?
26727 describes treatment of this shaft-fracture type with manipulation and skeletal traction. This code covers manipulation without that traction method.
Can the reduction and splinting be billed as separate fracture services?
The manipulation and immediate immobilization are part of the closed fracture treatment. Do not report the same treatment as an open or percutaneous fixation procedure.
Should modifier 50 be used for fractures on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service for each fracture treated, following applicable claim-edit instructions.
What documentation supports reporting this code?
Document the affected digit and phalanx, the shaft-fracture location, the manipulation performed, and the resulting treatment plan or immobilization.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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
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