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Billing code 26841: Thumb fusionMedicare rate & RVUs

Reports surgical fusion of the thumb carpometacarpal joint, commonly for painful basal-joint arthritis or instability requiring a stable thumb base.

CMS RVU26DEffective Oct 1, 2026109 payment localities122 Medicare services in 2024

Medicare pays $751.19 for 26841 nationally in a facility.

Medicare rate · 26841

Thumb fusion

Swap in your local Medicare rate.

Work RVUs
7.17
Total RVUs
22.49
Global days
090

National rate · 2026

$751.19

Facility setting, before claim adjustments.

See every locality for 26841 → · 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 26841 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 26841 covers

This procedure fuses the joint at the base of the thumb, where the first metacarpal meets the wrist-side carpal bone. The surgeon prepares the joint surfaces and may use internal fixation to hold the bones in position while they heal together. Hand surgeons commonly perform it in an operating room for selected patients with painful thumb-base arthritis, instability, or joint damage after trauma.

Report 26841 for the thumb carpometacarpal fusion when the service does not include the autogenous bone graft described by the graft-specific code. The operative report should identify the joint fused, the indication, the preparation and fixation performed, and whether a graft was used. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 identifies bilateral performance, paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeon payment requires supporting documentation. 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 26841 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

26841 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$672.67
Alaska*Unavailable$879.98
ArizonaUnavailable$730.00
ArkansasUnavailable$662.84
AtlantaUnavailable$768.80
AustinUnavailable$773.24
BakersfieldUnavailable$781.92
Baltimore/Surr. CntysUnavailable$800.10
BeaumontUnavailable$706.03
BrazoriaUnavailable$738.56

26841 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
26841 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 26841 rate is calculated

Each of 26841’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 · 26841

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.17Practice expense 13.91Malpractice 1.41

22.4900 adjusted RVUs×$33.4009 conversion factor=$751.19

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

Payment rules and modifiers for 26841

26841 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26841

Thumb fusion

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)0Not paid without supporting documentation.
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 · 26841

Thumb fusion

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

26841 without 50 · national facility

$751.19

Thumb fusion

26841-50 · Bilateral: 150%

$1,126.79

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

26841 compared with similar codes

Compare codes

26841 vs 26842 vs 26843 vs 26844 vs 25447: national Medicare rates

Swap in your local Medicare rate.

  • 26841
    Thumb fusion · 7.17 wRVU
    —
  • 26842
    Thumb fusion · 8.28 wRVU
    —
  • 26843
    Hand joint fusion · 7.59 wRVU
    —
  • 26844
    Hand joint fusion · 8.76 wRVU
    —
  • 25447
    Interposition arthroplasty · 10.24 wRVU
    —

How to choose

26842Thumb fusion
Both involve thumb carpometacarpal fusion, but 26842 is the graft-specific choice when autogenous bone graft is used.
26843Hand joint fusion
Use 26843 when the fused hand joint is not the thumb carpometacarpal joint; select by the anatomical joint treated.
26844Hand joint fusion
This is a graft-associated hand-joint fusion code for a different joint site, rather than thumb carpometacarpal fusion.
25447Interposition arthroplasty
This is a thumb-base arthroplasty approach rather than fusion; the surgeon preserves motion through joint reconstruction instead of creating a bony union.

Codes related to 26841

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

Codes related to 26841
CodeHow it relatesNational office range
Same family
26842Thumb fusionThumb carpometacarpal fusion code for the service involving autogenous bone graft.No office rate
26843Hand joint fusionHand-joint fusion at a different site; identify the joint treated.No office rate
26844Hand joint fusionHand-joint fusion with graft at a different site.No office rate
Used instead
25447Interposition arthroplastyThumb-base joint arthroplasty may be selected instead of fusion for basal-joint disease.No office rate

26841 billing questions

When should 26841 be chosen over 26842?

Use 26841 for thumb carpometacarpal fusion without the autogenous bone graft specified for 26842. If an autogenous graft is used, select the graft-specific code.

What documentation supports reporting 26841?

Document the thumb carpometacarpal joint fused, the clinical reason for fusion, the operative work, fixation used, and whether a bone graft was performed.

Does the code include related postoperative visits?

Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral thumb fusion reported?

Report bilateral performance with modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation.

Is payment reduced when another procedure is performed in the same session?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 26841PPRRVU2026_Oct_nonQPP.csv, line 2,692 (RVU26D)

Open CMS sourceHow we calculate rates

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