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Billing code 26842: Thumb fusionMedicare rate & RVUs

Reports fusion of the thumb’s carpometacarpal joint using autogenous bone graft, commonly for painful arthritis, instability, or post-traumatic joint damage.

CMS RVU26DEffective Oct 1, 2026109 payment localities95 Medicare services in 2024

Medicare pays $815.98 for 26842 nationally in a facility.

Medicare rate · 26842

Thumb fusion

Swap in your local Medicare rate.

Work RVUs
8.28
Total RVUs
24.43
Global days
090

National rate · 2026

$815.98

Facility setting, before claim adjustments.

See every locality for 26842 → · 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 26842 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 26842 covers

This operation fuses the carpometacarpal joint at the base of the thumb using the patient’s own bone graft. The surgeon prepares the joint surfaces, places graft to support fusion, and may use internal fixation to hold the bones in position. Hand or orthopedic surgeons commonly perform it in an operating room for symptomatic basal-joint arthritis, instability, or damage after trauma when fusion is selected. The graft-harvesting work is included in the service; document its source and use as part of the operative record.

Report this code when the operative documentation supports fusion of the thumb carpometacarpal joint with autogenous graft, rather than fusion of another thumb or hand joint or fusion without graft. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 26842 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

26842 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$730.39
Alaska*Unavailable$959.11
ArizonaUnavailable$792.62
ArkansasUnavailable$719.70
AtlantaUnavailable$836.32
AustinUnavailable$837.71
BakersfieldUnavailable$844.39
Baltimore/Surr. CntysUnavailable$869.43
BeaumontUnavailable$768.55
BrazoriaUnavailable$800.94

26842 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
26842 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 26842 rate is calculated

Each of 26842’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 · 26842

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.28Practice expense 14.39Malpractice 1.76

24.4300 adjusted RVUs×$33.4009 conversion factor=$815.98

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

Payment rules and modifiers for 26842

26842 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26842

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)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 · 26842

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

26842 without 50 · national facility

$815.98

Thumb fusion

26842-50 · Bilateral: 150%

$1,223.97

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

26842 compared with similar codes

Compare codes

26842 vs 26841 vs 26844 vs 26852: national Medicare rates

Swap in your local Medicare rate.

  • 26842
    Thumb fusion · 8.28 wRVU
    —
  • 26841
    Thumb fusion · 7.17 wRVU
    —
  • 26844
    Hand joint fusion · 8.76 wRVU
    —
  • 26852
    Knuckle fusion · 8.49 wRVU
    —

How to choose

26841Thumb fusion
Both describe thumb carpometacarpal fusion; choose 26842 when autogenous bone graft is used and 26841 when it is not.
26844Hand joint fusion
This code is for a grafted carpometacarpal fusion of a hand joint other than the thumb. Use 26842 when the fused joint is the thumb carpometacarpal joint.
26852Knuckle fusion
This code is for grafted metacarpophalangeal joint fusion. Code 26842 is for the thumb carpometacarpal joint.

Codes related to 26842

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

Codes related to 26842
CodeHow it relatesNational office range
Same family
26841Thumb fusionThumb carpometacarpal fusion without the autogenous graft reported with this code.No office rate
26843Hand joint fusionFusion of a hand carpometacarpal joint other than the thumb.No office rate
26844Hand joint fusionGrafted fusion of a hand carpometacarpal joint other than the thumb.No office rate
26850Knuckle fusionFusion of a metacarpophalangeal joint rather than the thumb carpometacarpal joint.No office rate
26852Knuckle fusionGrafted metacarpophalangeal joint fusion, at a different joint site.No office rate

26842 billing questions

How does this differ from 26841?

Use 26842 when the thumb carpometacarpal fusion includes autogenous bone graft. Code 26841 describes the corresponding fusion without graft.

Can the bone-graft harvest be billed separately?

The graft-obtaining work is included in this service. Document the graft source and its use in the fusion.

Which joint must be fused for this code?

The procedure must fuse the carpometacarpal joint at the base of the thumb. A fusion of a finger joint or another hand joint is not this service.

How is bilateral surgery reported?

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

What postoperative care is included?

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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
RVUs for 26842PPRRVU2026_Oct_nonQPP.csv, line 2,693 (RVU26D)

Open CMS sourceHow we calculate rates

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