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Billing code 26850: Knuckle fusionMedicare rate & RVUs

Reports surgical fusion of a finger metacarpophalangeal joint for conditions such as painful arthritis, instability, or post-traumatic deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.3K Medicare services in 2024

Medicare pays $706.43 for 26850 nationally in a facility.

Medicare rate · 26850

Knuckle fusion

Swap in your local Medicare rate.

Work RVUs
6.96
Total RVUs
21.15
Global days
090

National rate · 2026

$706.43

Facility setting, before claim adjustments.

See every locality for 26850 → · 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 26850 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 26850 covers

Code 26850 describes an operation to fuse a finger’s metacarpophalangeal (MCP) joint, the joint where the finger meets the hand. The surgeon prepares the joint surfaces and positions them for fusion; internal fixation may be used. Hand or orthopedic surgeons commonly perform the procedure in a hospital operating room or ambulatory surgery center for a painful, unstable, or deformed MCP joint, including after trauma.

Select this code for MCP fusion without autogenous bone graft; when autogenous graft is used, consider 26852. The operative report should identify the joint and side, the condition treated, and whether graft or fixation was used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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 26850 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

26850 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$633.56
Alaska*Unavailable$830.81
ArizonaUnavailable$686.75
ArkansasUnavailable$624.43
AtlantaUnavailable$722.87
AustinUnavailable$726.80
BakersfieldUnavailable$734.87
Baltimore/Surr. CntysUnavailable$751.98
BeaumontUnavailable$664.61
BrazoriaUnavailable$694.72

26850 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
26850 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 26850 rate is calculated

Each of 26850’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 · 26850

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.96Practice expense 12.87Malpractice 1.32

21.1500 adjusted RVUs×$33.4009 conversion factor=$706.43

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

Payment rules and modifiers for 26850

26850 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26850

Knuckle 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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
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 · 26850

Knuckle 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 51 · payment effect

With and without the modifier

26850 without 51 · national facility

$706.43

Knuckle fusion

26850-51 · Second procedure: 50%

$353.22

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

26850 compared with similar codes

Compare codes

26850 vs 26852 vs 26860 vs 26843 vs 26841: national Medicare rates

Swap in your local Medicare rate.

  • 26850
    Knuckle fusion · 6.96 wRVU
    —
  • 26852
    Knuckle fusion · 8.49 wRVU
    —
  • 26860
    Finger joint fusion · 4.76 wRVU
    —
  • 26843
    Hand joint fusion · 7.59 wRVU
    —
  • 26841
    Thumb fusion · 7.17 wRVU
    —

How to choose

26852Knuckle fusion
Both describe MCP fusion, but 26852 includes autogenous bone graft. Internal fixation alone does not call for the graft code.
26860Finger joint fusion
Use 26860 for fusion of a finger interphalangeal joint, not the MCP joint at the base of the finger.
26843Hand joint fusion
Code 26843 concerns fusion of a non-thumb carpometacarpal joint in the hand; 26850 concerns a finger MCP joint.
26841Thumb fusion
Code 26841 is for the thumb carpometacarpal joint. It is not the code for fusion of a finger MCP joint.

Codes related to 26850

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

Codes related to 26850
CodeHow it relatesNational office range
Same family
26852Knuckle fusionMCP fusion when autogenous bone graft is used.No office rate
26860Finger joint fusionFusion of a finger interphalangeal joint rather than an MCP joint.No office rate
26862Finger fusionInterphalangeal joint fusion with autogenous bone graft.No office rate
26843Hand joint fusionFusion at a non-thumb carpometacarpal joint, not a finger MCP joint.No office rate
26841Thumb fusionFusion of the thumb carpometacarpal joint.No office rate

26850 billing questions

When should 26852 be reported instead?

Use 26852 when the MCP fusion includes autogenous bone graft. Internal fixation by itself does not distinguish 26852 from 26850.

Is internal fixation included in 26850?

Yes. The code covers MCP fusion with or without internal fixation.

Does 26850 describe a finger MCP joint or an interphalangeal joint?

It describes the joint at the base of a finger, where the finger meets the hand. Fusion of a finger interphalangeal joint is in the 26860 code family.

Should modifier 50 be used for bilateral MCP fusions?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

What postoperative care is included?

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 26850PPRRVU2026_Oct_nonQPP.csv, line 2,696 (RVU26D)

Open CMS sourceHow we calculate rates

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