FeeBase
Log inGet started
Menu

Billing code 26765: Finger fractureMedicare rate & RVUs

Reports surgical exposure and treatment of a finger or thumb distal phalanx fracture, with direct reduction and fixation when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $486.65 for 26765 nationally in a facility.

Medicare rate · 26765

Finger fracture

Swap in your local Medicare rate.

Work RVUs
5.71
Total RVUs
14.57
Global days
090

National rate · 2026

$486.65

Facility setting, before claim adjustments.

See every locality for 26765 → · 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 26765 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 26765 covers

An orthopedic or hand surgeon reports this service when the distal phalanx of a finger or thumb is surgically exposed and the fracture is treated directly. The work may include reducing the fracture and stabilizing it with fixation, such as a wire, when needed. It is used for operative fracture care in an operating room or another appropriate surgical setting; the code describes the treatment approach, not whether the fracture itself was open or closed.

Document the injured digit, distal phalanx fracture, operative exposure, reduction, and fixation performed. Report each treated fracture as supported by the record; internal fixation is part of the service when performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS 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 26765 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

26765 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$438.10
Alaska*Unavailable$582.02
ArizonaUnavailable$473.25
ArkansasUnavailable$432.06
AtlantaUnavailable$498.88
AustinUnavailable$497.76
BakersfieldUnavailable$500.47
Baltimore/Surr. CntysUnavailable$517.44
BeaumontUnavailable$460.73
BrazoriaUnavailable$477.62

26765 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
26765 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 26765 rate is calculated

Each of 26765’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 · 26765

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.71Practice expense 7.74Malpractice 1.12

14.5700 adjusted RVUs×$33.4009 conversion factor=$486.65

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

Payment rules and modifiers for 26765

26765 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26765

Finger fracture

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)1Not paid (statutory restriction).
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 · 26765

Finger fracture

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

26765 without 51 · national facility

$486.65

Finger fracture

26765-51 · Second procedure: 50%

$243.33

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

26765 compared with similar codes

Compare codes

26765 vs 26750 vs 26755 vs 26756 vs 26735: national Medicare rates

Swap in your local Medicare rate.

  • 26765
    Finger fracture · 5.71 wRVU
    —
  • 26750
    Finger fracture care · 1.76 wRVU
    $220.45
  • 26755
    Finger fracture care · 3.15 wRVU
    $381.10
  • 26756
    Fracture fixation · 4.47 wRVU
    —
  • 26735
    Finger fracture repair · 7.23 wRVU
    —

How to choose

26750Finger fracture care
26750 describes closed treatment of a distal phalanx fracture without manipulation. Choose 26765 when the fracture is surgically exposed and treated.
26755Finger fracture care
26755 is closed treatment with manipulation; it does not describe open surgical treatment.
26756Fracture fixation
26756 describes percutaneous skeletal fixation of a distal phalanx fracture. Use 26765 when treatment involves surgical exposure.
26735Finger fracture repair
26735 is for open treatment of a proximal or middle phalangeal shaft fracture, rather than a distal phalanx fracture.

Codes related to 26765

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

Codes related to 26765
CodeHow it relatesNational office range
Same family
26750Finger fracture careClosed treatment of a distal phalanx fracture without manipulation.$193.40–$287.17
26755Finger fracture careClosed treatment of a distal phalanx fracture with manipulation.$334.39–$494.04
26756Fracture fixationPercutaneous skeletal fixation of a distal phalanx fracture.No office rate
26720Finger fracture careClosed treatment without manipulation for a proximal or middle phalangeal shaft fracture.$206.24–$309.59
26735Finger fracture repairOpen treatment of a proximal or middle phalangeal shaft fracture.No office rate
26746Finger fracture repairOpen treatment of an articular fracture involving a finger joint.No office rate

26765 billing questions

How is this different from 26750 or 26755?

This code is for open surgical treatment of a distal phalanx fracture. Codes 26750 and 26755 describe closed treatment, without and with manipulation, respectively.

When would 26756 be a better fit?

Use 26756 for percutaneous skeletal fixation of a distal phalanx fracture. This code describes treatment through surgical exposure.

Is internal fixation separately reported?

Fixation performed as part of treating the fracture is included in this service. Document the method used and the fracture reduction.

What documentation supports reporting the code?

Record the finger or thumb and distal phalanx involved, the fracture treated, surgical exposure, reduction, and any fixation. Identify each fracture when reporting more than one.

Can modifier 50 be used for fractures on both hands?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

What postoperative care is included?

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

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 26765PPRRVU2026_Oct_nonQPP.csv, line 2,686 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26765 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 26765 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →