No office rate
Choose 26591 for repair of an intrinsic hand muscle. Choose 26593 when the procedure releases intrinsic muscle tightness.
On this page
CMS RVU26D · Effective 2026-10-01
26591 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$519.29
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Hand surgery
About 26591: Intrinsic muscle repair of the hand
Reports operative repair of injured intrinsic hand muscles, such as interossei or lumbricals, when the procedure restores the muscle’s continuity or function.
This code covers surgical repair of intrinsic muscles within the hand, including muscles such as the interossei and lumbricals. A hand surgeon or other qualified surgical specialist may perform the repair for a disrupted muscle, such as after a hand injury. The service is generally performed in an operating room; the operative report should identify the injured muscle and describe the repair performed.
Report the code for the intrinsic muscle repair itself, not for a repair directed at a joint or a release of tight intrinsic muscles. Document the affected anatomy, side, and operative work so the service can be distinguished from those procedures. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26591
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.30 · 22%
- Practice expense (office) RVU10.82 · 73%
- Malpractice RVU0.62 · 4%
190
Medicare services in 2024 · #4364 by national volume
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.
26591 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
26540 addresses repair of a hand joint. This code addresses repair of intrinsic muscle tissue, not the joint.
No office rate
26541 describes hand-joint repair with graft; 26591 is for intrinsic muscle repair and does not describe a grafted joint repair.
The same code, a different location
How does Merced compare?
26591 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Modesto
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Napa
California · 26591
Office
Unavailable
Facility
$604.01
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 26591
Office
Unavailable
Facility
$553.38
No comparable office rate is available.
Redding
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Rest Of California
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 26591
Office
Unavailable
Facility
$525.96
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 26591
Office
Unavailable
Facility
$545.60
No comparable office rate is available.
Salinas
California · 26591
Office
Unavailable
Facility
$543.60
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 26591
Office
Unavailable
Facility
$556.99
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 26591
Office
Unavailable
Facility
$639.77
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 26591
Office
Unavailable
Facility
$639.07
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 26591
Office
Unavailable
Facility
$654.58
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 26591
Office
Unavailable
Facility
$651.70
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 26591
Office
Unavailable
Facility
$534.83
No comparable office rate is available.
Santa Cruz-Watsonville
California · 26591
Office
Unavailable
Facility
$562.74
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 26591
Office
Unavailable
Facility
$545.80
No comparable office rate is available.
Santa Rosa-Petaluma
California · 26591
Office
Unavailable
Facility
$568.43
No comparable office rate is available.
Stockton
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Vallejo
California · 26591
Office
Unavailable
Facility
$602.99
No comparable office rate is available.
Visalia
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Yuba City
California · 26591
Office
Unavailable
Facility
$519.29
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 26591
Office
Unavailable
Facility
$564.95
No comparable office rate is available.
Miami
Florida · 26591
Office
Unavailable
Facility
$538.81
No comparable office rate is available.
Chicago
Illinois · 26591
Office
Unavailable
Facility
$521.73
No comparable office rate is available.
Manhattan
New York · 26591
Office
Unavailable
Facility
$570.07
No comparable office rate is available.
Alaska*
Alaska · 26591
Office
Unavailable
Facility
$561.63
No comparable office rate is available.
Alabama
Alabama · 26591
Office
Unavailable
Facility
$438.17
No comparable office rate is available.
Arkansas
Arkansas · 26591
Office
Unavailable
Facility
$431.33
No comparable office rate is available.
Arizona
Arizona · 26591
Office
Unavailable
Facility
$478.14
No comparable office rate is available.
Colorado
Colorado · 26591
Office
Unavailable
Facility
$512.25
No comparable office rate is available.
Connecticut
Connecticut · 26591
Office
Unavailable
Facility
$526.71
No comparable office rate is available.
Delaware
Delaware · 26591
Office
Unavailable
Facility
$486.45
No comparable office rate is available.
Fort Lauderdale
Florida · 26591
Office
Unavailable
Facility
$513.76
No comparable office rate is available.
Rest Of Florida
Florida · 26591
Office
Unavailable
Facility
$486.84
No comparable office rate is available.
Atlanta
Georgia · 26591
Office
Unavailable
Facility
$502.60
No comparable office rate is available.
Rest Of Georgia
Georgia · 26591
Office
Unavailable
Facility
$457.27
No comparable office rate is available.
Hawaii, Guam
Hawaii · 26591
Office
Unavailable
Facility
$533.12
No comparable office rate is available.
Iowa
Iowa · 26591
Office
Unavailable
Facility
$449.12
No comparable office rate is available.
Idaho
Idaho · 26591
Office
Unavailable
Facility
$452.50
No comparable office rate is available.
East St. Louis
Illinois · 26591
Office
Unavailable
Facility
$484.42
No comparable office rate is available.
Rest Of Illinois
Illinois · 26591
Office
Unavailable
Facility
$472.55
No comparable office rate is available.
Suburban Chicago
Illinois · 26591
Office
Unavailable
Facility
$518.85
No comparable office rate is available.
Indiana
Indiana · 26591
Office
Unavailable
Facility
$455.30
No comparable office rate is available.
Kansas
Kansas · 26591
Office
Unavailable
Facility
$447.36
No comparable office rate is available.
Kentucky
Kentucky · 26591
Office
Unavailable
Facility
$450.45
No comparable office rate is available.
New Orleans
Louisiana · 26591
Office
Unavailable
Facility
$473.82
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 26591
Office
Unavailable
Facility
$449.90
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 26591
Office
Unavailable
Facility
$564.68
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 26591
Office
Unavailable
Facility
$509.04
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 26591
Office
Unavailable
Facility
$525.38
No comparable office rate is available.
Rest Of Maryland
Maryland · 26591
Office
Unavailable
Facility
$496.07
No comparable office rate is available.
Rest Of Maine
Maine · 26591
Office
Unavailable
Facility
$455.59
No comparable office rate is available.
Southern Maine
Maine · 26591
Office
Unavailable
Facility
$481.44
No comparable office rate is available.
Detroit
Michigan · 26591
Office
Unavailable
Facility
$493.89
No comparable office rate is available.
Rest Of Michigan
Michigan · 26591
Office
Unavailable
Facility
$463.56
No comparable office rate is available.
Minnesota
Minnesota · 26591
Office
Unavailable
Facility
$488.23
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 26591
Office
Unavailable
Facility
$469.81
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 26591
Office
Unavailable
Facility
$475.02
No comparable office rate is available.
Rest Of Missouri
Missouri · 26591
Office
Unavailable
Facility
$441.92
No comparable office rate is available.
Mississippi
Mississippi · 26591
Office
Unavailable
Facility
$436.69
No comparable office rate is available.
Montana**
Montana · 26591
Office
Unavailable
Facility
$492.29
No comparable office rate is available.
North Carolina
North Carolina · 26591
Office
Unavailable
Facility
$460.64
No comparable office rate is available.
North Dakota**
North Dakota · 26591
Office
Unavailable
Facility
$480.03
No comparable office rate is available.
Nebraska
Nebraska · 26591
Office
Unavailable
Facility
$451.62
No comparable office rate is available.
New Hampshire
New Hampshire · 26591
Office
Unavailable
Facility
$504.56
No comparable office rate is available.
Northern Nj
New Jersey · 26591
Office
Unavailable
Facility
$558.51
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 26591
Office
Unavailable
Facility
$532.00
No comparable office rate is available.
New Mexico
New Mexico · 26591
Office
Unavailable
Facility
$466.50
No comparable office rate is available.
Nevada**
Nevada · 26591
Office
Unavailable
Facility
$489.23
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 26591
Office
Unavailable
Facility
$585.43
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 26591
Office
Unavailable
Facility
$535.97
No comparable office rate is available.
Queens
New York · 26591
Office
Unavailable
Facility
$574.31
No comparable office rate is available.
Rest Of New York
New York · 26591
Office
Unavailable
Facility
$468.11
No comparable office rate is available.
Ohio
Ohio · 26591
Office
Unavailable
Facility
$461.05
No comparable office rate is available.
Oklahoma
Oklahoma · 26591
Office
Unavailable
Facility
$449.04
No comparable office rate is available.
Portland
Oregon · 26591
Office
Unavailable
Facility
$528.91
No comparable office rate is available.
Rest Of Oregon
Oregon · 26591
Office
Unavailable
Facility
$484.73
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 26591
Office
Unavailable
Facility
$513.13
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 26591
Office
Unavailable
Facility
$461.56
No comparable office rate is available.
Puerto Rico
Puerto Rico · 26591
Office
Unavailable
Facility
$495.99
No comparable office rate is available.
Rhode Island
Rhode Island · 26591
Office
Unavailable
Facility
$504.11
No comparable office rate is available.
South Carolina
South Carolina · 26591
Office
Unavailable
Facility
$461.76
No comparable office rate is available.
South Dakota**
South Dakota · 26591
Office
Unavailable
Facility
$478.58
No comparable office rate is available.
Tennessee
Tennessee · 26591
Office
Unavailable
Facility
$449.85
No comparable office rate is available.
Austin
Texas · 26591
Office
Unavailable
Facility
$511.15
No comparable office rate is available.
Beaumont
Texas · 26591
Office
Unavailable
Facility
$458.33
No comparable office rate is available.
Brazoria
Texas · 26591
Office
Unavailable
Facility
$485.40
No comparable office rate is available.
Dallas
Texas · 26591
Office
Unavailable
Facility
$488.94
No comparable office rate is available.
Fort Worth
Texas · 26591
Office
Unavailable
Facility
$485.59
No comparable office rate is available.
Galveston
Texas · 26591
Office
Unavailable
Facility
$487.12
No comparable office rate is available.
Houston
Texas · 26591
Office
Unavailable
Facility
$498.47
No comparable office rate is available.
Rest Of Texas
Texas · 26591
Office
Unavailable
Facility
$471.89
No comparable office rate is available.
Utah
Utah · 26591
Office
Unavailable
Facility
$468.53
No comparable office rate is available.
Virginia
Virginia · 26591
Office
Unavailable
Facility
$480.10
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 26591
Office
Unavailable
Facility
$495.99
No comparable office rate is available.
Vermont
Vermont · 26591
Office
Unavailable
Facility
$478.49
No comparable office rate is available.
Rest Of Washington
Washington · 26591
Office
Unavailable
Facility
$507.97
No comparable office rate is available.
Seattle (King Cnty)
Washington · 26591
Office
Unavailable
Facility
$576.09
No comparable office rate is available.
Wisconsin
Wisconsin · 26591
Office
Unavailable
Facility
$462.82
No comparable office rate is available.
West Virginia
West Virginia · 26591
Office
Unavailable
Facility
$453.91
No comparable office rate is available.
Wyoming**
Wyoming · 26591
Office
Unavailable
Facility
$486.95
No comparable office rate is available.
See how rates vary across the country
26591 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 26591 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$571.22
$519.29 × 110% = $571.22
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 26591 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,655
- Code
- 26591
- Physician work
- 3.30
- Practice expense
- 10.82
- Malpractice
- 0.62
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.30 | × 1.017 | 3.3561 |
| Practice expense | 10.82 | × 1.096 | 11.8587 |
| Malpractice | 0.62 | × 0.536 | 0.3323 |
| Total RVUs | 15.5471 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$519.29
Open 26591 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.3 | 1.017 |
| Practice expense | 10.82 | 1.096 |
| Malpractice | 0.62 | 0.536 |
(3.3 × 1.017 + 10.82 × 1.096 + 0.62 × 0.536) × $33.4009 = $519.29
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
26591 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $519.29 | RVU26D |
| 2026-07-01 | Not available in this setting | $519.29 | RVU26C |
| 2026-04-01 | Not available in this setting | $519.29 | RVU26B |
| 2026-01-01 | Not available in this setting | $519.29 | RVU26A |
| 2025-10-01 | Not available in this setting | $504.46 | RVU25D |
| 2025-07-01 | Not available in this setting | $504.46 | RVU25C |
| 2025-04-01 | Not available in this setting | $504.46 | RVU25B |
| 2025-01-01 | Not available in this setting | $504.46 | RVU25A |
26591 billing questions
How is this code different from 26593?
26591 reports repair of an intrinsic hand muscle. 26593 is for releasing intrinsic muscles when tightness or contracture is the operative problem.
Can this code be used for a hand joint repair?
No. Use a joint-repair code, such as 26540 when its service applies, for repair directed at the hand joint rather than the intrinsic muscle.
Should modifier 50 be appended for repairs on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.
What documentation supports reporting 26591?
The operative report should identify the intrinsic muscle repaired, the side, the injury or disruption addressed, and the repair performed.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,65226580,,Repair cleft hand,A,,19.26,19.99,NA,19.99,,4.10,43.35,43.35,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65326587,,Reconstruct extra finger,A,,14.14,11.93,NA,11.93,,3.01,29.08,29.08,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65426590,,Repair finger deformity,A,,18.20,18.03,NA,18.03,,3.88,40.11,40.11,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65526591,,Repair muscles of hand,A,,3.30,10.82,NA,10.82,,0.62,14.74,14.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65626593,,Release muscles of hand,A,,5.36,12.63,NA,12.63,,1.04,19.03,19.03,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65726596,,Excision constricting tissue,A,,8.91,12.91,NA,12.91,,1.91,23.73,23.73,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65826600,,Treat metacarpal fracture,A,,2.54,7.20,,5.97,,0.49,10.23,9.00,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623