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Billing code 26852: Knuckle fusionMedicare rate & RVUs

Reports fusion of a finger’s metacarpophalangeal joint using internal fixation and bone graft, such as for painful arthritis or joint instability.

CMS RVU26DEffective Oct 1, 2026109 payment localities769 Medicare services in 2024

Medicare pays $795.28 for 26852 nationally in a facility.

Medicare rate · 26852

Knuckle fusion

Work RVUs
8.49
Total RVUs
23.81
Global days
090

National rate · 2026

$795.28

Facility setting, before claim adjustments.

See every locality for 26852 →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 26852 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 26852 covers

This service fuses a metacarpophalangeal (MCP) joint—the knuckle where a finger meets the hand—using internal fixation and bone graft. A hand or orthopedic surgeon may perform it for a painful, unstable, or severely damaged joint, including after trauma or when arthritis has made motion unreliable. The code’s graft component includes obtaining the autograft. It is for an MCP joint, not a thumb carpometacarpal joint or a finger interphalangeal joint.

Report the code for the MCP fusion with fixation and graft, identifying the digit and documenting the condition, operative work, fixation, and graft use. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When other procedures are performed 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 is inappropriate for this code. An assistant at surgery may be paid; 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 26852 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

26852 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$714.70
Alaska*Unavailable$942.68
ArizonaUnavailable$773.34
ArkansasUnavailable$704.63
AtlantaUnavailable$814.26
AustinUnavailable$816.27
BakersfieldUnavailable$823.60
Baltimore/Surr. CntysUnavailable$845.99
BeaumontUnavailable$750.24
BrazoriaUnavailable$781.59

26852 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
26852 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 26852 rate is calculated

Each of 26852’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 · 26852

RVUs × geographic indexes × conversion factor

Work8.49

8.49 RVUs× 1.000 GPCI

Practice expense13.71

13.71 RVUs× 1.000 GPCI

Malpractice1.61

1.61 RVUs× 1.000 GPCI

Adjusted RVUs

23.8100

Conversion factor

$33.4009

Medicare rate

$795.28

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26852

26852 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26852

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)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 · 26852

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

26852 without 51 · national facility

$795.28

Knuckle fusion

26852-51 · Second procedure: 50%

$397.64

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

26852 compared with similar codes

Compare codes · National

5 codes, side by side

  • 26852

    Knuckle fusion8.49 wRVU

    Not priced

  • 26850

    Knuckle fusion6.96 wRVU

    Not priced

  • 26860

    Finger joint fusion4.76 wRVU

    Not priced

  • 26862

    Finger fusion7.37 wRVU

    Not priced

  • 26844

    Hand joint fusion8.76 wRVU

    Not priced

How to choose

26850Knuckle fusion
Both address an MCP joint. Choose 26852 when the fusion uses internal fixation and bone graft; 26850 describes MCP fusion without internal fixation.
26860Finger joint fusion
26860 is for a finger interphalangeal joint, such as a joint within the finger. 26852 is for the MCP knuckle where the finger meets the hand.
26862Finger fusion
26862 describes graft-assisted fusion at a finger interphalangeal joint. Use 26852 when the fused joint is the MCP joint.
26844Hand joint fusion
26844 is for graft-assisted fusion of a non-thumb carpometacarpal joint. 26852 is for fusion of a finger MCP joint.

Codes related to 26852

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

Codes related to 26852
CodeHow it relatesNational office range
Same family
26850Knuckle fusionMCP fusion without internal fixation; distinguish by the fixation and graft work.No office rate
Used instead
26860Finger joint fusionFinger interphalangeal fusion, for a different joint level.No office rate
26862Finger fusionFinger interphalangeal fusion with graft, for a different joint level.No office rate
26843Hand joint fusionFusion of a non-thumb carpometacarpal joint, not an MCP knuckle.No office rate
26844Hand joint fusionGraft-assisted fusion of a non-thumb carpometacarpal joint.No office rate

26852 billing questions

How does 26852 differ from 26850?

26852 describes MCP fusion using internal fixation and bone graft. 26850 is the related MCP fusion code without internal fixation.

Can the bone-graft harvest be billed separately?

The graft component of 26852 includes obtaining the autograft. Do not report a separate harvest charge for that included work.

Which joint does 26852 cover?

It covers a finger metacarpophalangeal joint at the knuckle. A thumb carpometacarpal fusion or a finger interphalangeal fusion is coded from a different part of the arthrodesis family.

What documentation supports reporting 26852?

The operative report should identify the digit and MCP joint, the fusion performed, use of internal fixation, and the bone graft. Document the clinical reason for fusion, such as joint pain or instability.

Should modifier 50 be used for bilateral MCP fusions?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the applicable coding instructions for each procedure performed.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

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 26852PPRRVU2026_Oct_nonQPP.csv, line 2,697 (RVU26D)

Open CMS sourceHow we calculate rates

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