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Billing code 26820: Thumb arthrodesisMedicare rate & RVUs

Reports surgical fusion of the thumb interphalangeal joint using bone graft, typically for painful instability, arthritis, or joint damage.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $813.98 for 26820 nationally in a facility.

Medicare rate · 26820

Thumb arthrodesis

Swap in your local Medicare rate.

Work RVUs
8.24
Total RVUs
24.37
Global days
090

National rate · 2026

$813.98

Facility setting, before claim adjustments.

See every locality for 26820 → · 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 26820 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 26820 covers

The surgeon prepares the opposing surfaces of the thumb interphalangeal joint and joins them to create a stable fusion, using bone graft and fixation as needed. Hand or orthopedic surgeons typically perform this procedure in an operating room for problems such as painful arthritis, post-traumatic joint damage, or persistent instability. The graft supports fusion; the operative service includes obtaining an autogenous graft when one is used.

Report this code for fusion of the thumb interphalangeal joint with graft, not fusion of the thumb’s carpometacarpal or metacarpophalangeal joint. The operative report should identify the joint, the graft used and its source, and the fixation or fusion technique. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 26820 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

26820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$728.57
Alaska*Unavailable$956.57
ArizonaUnavailable$790.67
ArkansasUnavailable$717.91
AtlantaUnavailable$834.24
AustinUnavailable$835.72
BakersfieldUnavailable$842.46
Baltimore/Surr. CntysUnavailable$867.30
BeaumontUnavailable$766.60
BrazoriaUnavailable$799.00

26820 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
26820 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 26820 rate is calculated

Each of 26820’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 · 26820

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.24Practice expense 14.38Malpractice 1.75

24.3700 adjusted RVUs×$33.4009 conversion factor=$813.98

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

Payment rules and modifiers for 26820

26820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26820

Thumb arthrodesis

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 26820

Thumb arthrodesis

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 50 · payment effect

With and without the modifier

26820 without 50 · national facility

$813.98

Thumb arthrodesis

26820-50 · Bilateral: 150%

$1,220.97

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

26820 compared with similar codes

Compare codes

26820 vs 26860 vs 26862 vs 26842: national Medicare rates

Swap in your local Medicare rate.

  • 26820
    Thumb arthrodesis · 8.24 wRVU
    —
  • 26860
    Finger joint fusion · 4.76 wRVU
    —
  • 26862
    Finger fusion · 7.37 wRVU
    —
  • 26842
    Thumb fusion · 8.28 wRVU
    —

How to choose

26860Finger joint fusion
Use 26860 for interphalangeal fusion of a finger without the thumb-and-graft combination described here.
26862Finger fusion
Use 26862 for graft-assisted interphalangeal fusion of a finger; this code is for the thumb.
26842Thumb fusion
Use 26842 when the fused joint is the thumb carpometacarpal joint, not the thumb interphalangeal joint.

Codes related to 26820

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

Codes related to 26820
CodeHow it relatesNational office range
Same family
26860Finger joint fusionFusion of an interphalangeal joint without the graft distinction for a thumb.No office rate
26862Finger fusionGraft-assisted interphalangeal fusion for a finger rather than the thumb.No office rate
26841Thumb fusionThumb fusion at the carpometacarpal joint rather than the interphalangeal joint.No office rate
26842Thumb fusionGraft-assisted thumb carpometacarpal fusion, at a different joint.No office rate

26820 billing questions

How is this code distinguished from thumb CMC fusion?

This code is for fusion of the thumb interphalangeal joint with graft. Thumb CMC fusion targets the joint at the base of the thumb.

Is graft harvesting separately reported?

The service includes obtaining an autogenous graft when one is used. Document the graft and its source in the operative report.

What should the operative report document?

Identify the thumb interphalangeal joint, the reason for fusion, the graft used and its source, and the method of fixation or fusion.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays this procedure at 150%.

How does the global period affect postoperative visits?

The 90-day global period includes the day-before preoperative visit and 90 days of 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 26820PPRRVU2026_Oct_nonQPP.csv, line 2,691 (RVU26D)

Open CMS sourceHow we calculate rates

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