No office rate
Use 26516 when the MCP joint is fused. Code 26530 describes MCP arthroplasty rather than fusion.
On this page
CMS RVU26D · Effective 2026-10-01
26516 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$741.86
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 26516: Metacarpophalangeal joint fusion
Reports surgical fusion of a metacarpophalangeal joint when the surgeon permanently stabilizes a finger or thumb knuckle.
The surgeon removes or prepares the opposing joint surfaces and positions the bones for permanent fusion, using fixation when needed. This operation may be performed by a hand or orthopedic surgeon for a painful, unstable, or severely damaged metacarpophalangeal (MCP) joint. The MCP joint is where a finger or thumb meets the hand; the operative report should identify the joint and document the reason for fusion and work performed.
Report 26516 for the MCP fusion itself, whether or not internal fixation is used. The 90-day global period includes 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 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 26516
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU7.14 · 33%
- Practice expense (office) RVU12.97 · 60%
- Malpractice RVU1.37 · 6%
853
Medicare services in 2024 · #3092 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.
26516 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
Code 26531 describes MCP arthroplasty with an implant; 26516 is for MCP fusion, with or without fixation.
No office rate
Code 26520 releases an MCP contracture. It does not describe permanently fusing the joint.
No office rate
Both are nearby MCP fusion codes. Use the complete code descriptors and operative documentation to distinguish the specific service reported.
The same code, a different location
How does Modesto compare?
26516 across payment areas
Same release and payment basis · bars start at $0
Modesto · 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 · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Merced
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Napa
California · 26516
Office
Unavailable
Facility
$847.72
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 26516
Office
Unavailable
Facility
$785.72
No comparable office rate is available.
Redding
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Rest Of California
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 26516
Office
Unavailable
Facility
$756.61
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 26516
Office
Unavailable
Facility
$775.42
No comparable office rate is available.
Salinas
California · 26516
Office
Unavailable
Facility
$772.49
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 26516
Office
Unavailable
Facility
$788.56
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 26516
Office
Unavailable
Facility
$892.97
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 26516
Office
Unavailable
Facility
$891.41
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 26516
Office
Unavailable
Facility
$913.93
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 26516
Office
Unavailable
Facility
$907.57
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 26516
Office
Unavailable
Facility
$760.49
No comparable office rate is available.
Santa Cruz-Watsonville
California · 26516
Office
Unavailable
Facility
$794.37
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 26516
Office
Unavailable
Facility
$774.81
No comparable office rate is available.
Santa Rosa-Petaluma
California · 26516
Office
Unavailable
Facility
$802.15
No comparable office rate is available.
Stockton
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Vallejo
California · 26516
Office
Unavailable
Facility
$845.48
No comparable office rate is available.
Visalia
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Yuba City
California · 26516
Office
Unavailable
Facility
$741.86
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 26516
Office
Unavailable
Facility
$812.61
No comparable office rate is available.
Miami
Florida · 26516
Office
Unavailable
Facility
$805.18
No comparable office rate is available.
Chicago
Illinois · 26516
Office
Unavailable
Facility
$780.54
No comparable office rate is available.
Manhattan
New York · 26516
Office
Unavailable
Facility
$829.71
No comparable office rate is available.
Alaska*
Alaska · 26516
Office
Unavailable
Facility
$844.31
No comparable office rate is available.
Alabama
Alabama · 26516
Office
Unavailable
Facility
$643.44
No comparable office rate is available.
Arkansas
Arkansas · 26516
Office
Unavailable
Facility
$634.18
No comparable office rate is available.
Arizona
Arizona · 26516
Office
Unavailable
Facility
$697.43
No comparable office rate is available.
Colorado
Colorado · 26516
Office
Unavailable
Facility
$738.02
No comparable office rate is available.
Connecticut
Connecticut · 26516
Office
Unavailable
Facility
$765.19
No comparable office rate is available.
Delaware
Delaware · 26516
Office
Unavailable
Facility
$708.82
No comparable office rate is available.
Fort Lauderdale
Florida · 26516
Office
Unavailable
Facility
$760.06
No comparable office rate is available.
Rest Of Florida
Florida · 26516
Office
Unavailable
Facility
$721.41
No comparable office rate is available.
Atlanta
Georgia · 26516
Office
Unavailable
Facility
$734.30
No comparable office rate is available.
Rest Of Georgia
Georgia · 26516
Office
Unavailable
Facility
$679.45
No comparable office rate is available.
Hawaii, Guam
Hawaii · 26516
Office
Unavailable
Facility
$757.54
No comparable office rate is available.
Iowa
Iowa · 26516
Office
Unavailable
Facility
$653.04
No comparable office rate is available.
Idaho
Idaho · 26516
Office
Unavailable
Facility
$658.68
No comparable office rate is available.
East St. Louis
Illinois · 26516
Office
Unavailable
Facility
$729.19
No comparable office rate is available.
Rest Of Illinois
Illinois · 26516
Office
Unavailable
Facility
$705.52
No comparable office rate is available.
Suburban Chicago
Illinois · 26516
Office
Unavailable
Facility
$766.14
No comparable office rate is available.
Indiana
Indiana · 26516
Office
Unavailable
Facility
$662.31
No comparable office rate is available.
Kansas
Kansas · 26516
Office
Unavailable
Facility
$653.17
No comparable office rate is available.
Kentucky
Kentucky · 26516
Office
Unavailable
Facility
$665.48
No comparable office rate is available.
New Orleans
Louisiana · 26516
Office
Unavailable
Facility
$698.12
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 26516
Office
Unavailable
Facility
$665.71
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 26516
Office
Unavailable
Facility
$806.24
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 26516
Office
Unavailable
Facility
$734.94
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 26516
Office
Unavailable
Facility
$763.74
No comparable office rate is available.
Rest Of Maryland
Maryland · 26516
Office
Unavailable
Facility
$721.28
No comparable office rate is available.
Rest Of Maine
Maine · 26516
Office
Unavailable
Facility
$665.50
No comparable office rate is available.
Southern Maine
Maine · 26516
Office
Unavailable
Facility
$696.67
No comparable office rate is available.
Detroit
Michigan · 26516
Office
Unavailable
Facility
$733.68
No comparable office rate is available.
Rest Of Michigan
Michigan · 26516
Office
Unavailable
Facility
$685.67
No comparable office rate is available.
Minnesota
Minnesota · 26516
Office
Unavailable
Facility
$697.80
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 26516
Office
Unavailable
Facility
$689.97
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 26516
Office
Unavailable
Facility
$696.75
No comparable office rate is available.
Rest Of Missouri
Missouri · 26516
Office
Unavailable
Facility
$656.48
No comparable office rate is available.
Mississippi
Mississippi · 26516
Office
Unavailable
Facility
$645.29
No comparable office rate is available.
Montana**
Montana · 26516
Office
Unavailable
Facility
$717.36
No comparable office rate is available.
North Carolina
North Carolina · 26516
Office
Unavailable
Facility
$671.91
No comparable office rate is available.
North Dakota**
North Dakota · 26516
Office
Unavailable
Facility
$690.27
No comparable office rate is available.
Nebraska
Nebraska · 26516
Office
Unavailable
Facility
$655.63
No comparable office rate is available.
New Hampshire
New Hampshire · 26516
Office
Unavailable
Facility
$729.49
No comparable office rate is available.
Northern Nj
New Jersey · 26516
Office
Unavailable
Facility
$804.90
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 26516
Office
Unavailable
Facility
$771.28
No comparable office rate is available.
New Mexico
New Mexico · 26516
Office
Unavailable
Facility
$690.69
No comparable office rate is available.
Nevada**
Nevada · 26516
Office
Unavailable
Facility
$710.24
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 26516
Office
Unavailable
Facility
$853.81
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 26516
Office
Unavailable
Facility
$778.95
No comparable office rate is available.
Queens
New York · 26516
Office
Unavailable
Facility
$831.78
No comparable office rate is available.
Rest Of New York
New York · 26516
Office
Unavailable
Facility
$682.20
No comparable office rate is available.
Ohio
Ohio · 26516
Office
Unavailable
Facility
$680.13
No comparable office rate is available.
Oklahoma
Oklahoma · 26516
Office
Unavailable
Facility
$660.89
No comparable office rate is available.
Portland
Oregon · 26516
Office
Unavailable
Facility
$757.64
No comparable office rate is available.
Rest Of Oregon
Oregon · 26516
Office
Unavailable
Facility
$702.13
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 26516
Office
Unavailable
Facility
$748.34
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 26516
Office
Unavailable
Facility
$679.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 26516
Office
Unavailable
Facility
$721.53
No comparable office rate is available.
Rhode Island
Rhode Island · 26516
Office
Unavailable
Facility
$731.34
No comparable office rate is available.
South Carolina
South Carolina · 26516
Office
Unavailable
Facility
$677.66
No comparable office rate is available.
South Dakota**
South Dakota · 26516
Office
Unavailable
Facility
$687.07
No comparable office rate is available.
Tennessee
Tennessee · 26516
Office
Unavailable
Facility
$656.84
No comparable office rate is available.
Austin
Texas · 26516
Office
Unavailable
Facility
$737.84
No comparable office rate is available.
Beaumont
Texas · 26516
Office
Unavailable
Facility
$675.21
No comparable office rate is available.
Brazoria
Texas · 26516
Office
Unavailable
Facility
$705.39
No comparable office rate is available.
Dallas
Texas · 26516
Office
Unavailable
Facility
$711.37
No comparable office rate is available.
Fort Worth
Texas · 26516
Office
Unavailable
Facility
$707.63
No comparable office rate is available.
Galveston
Texas · 26516
Office
Unavailable
Facility
$708.46
No comparable office rate is available.
Houston
Texas · 26516
Office
Unavailable
Facility
$733.53
No comparable office rate is available.
Rest Of Texas
Texas · 26516
Office
Unavailable
Facility
$690.92
No comparable office rate is available.
Utah
Utah · 26516
Office
Unavailable
Facility
$686.79
No comparable office rate is available.
Virginia
Virginia · 26516
Office
Unavailable
Facility
$696.63
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 26516
Office
Unavailable
Facility
$721.53
No comparable office rate is available.
Vermont
Vermont · 26516
Office
Unavailable
Facility
$690.51
No comparable office rate is available.
Rest Of Washington
Washington · 26516
Office
Unavailable
Facility
$732.58
No comparable office rate is available.
Seattle (King Cnty)
Washington · 26516
Office
Unavailable
Facility
$819.34
No comparable office rate is available.
Wisconsin
Wisconsin · 26516
Office
Unavailable
Facility
$667.59
No comparable office rate is available.
West Virginia
West Virginia · 26516
Office
Unavailable
Facility
$680.42
No comparable office rate is available.
Wyoming**
Wyoming · 26516
Office
Unavailable
Facility
$705.55
No comparable office rate is available.
See how rates vary across the country
26516 · 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?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 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 26516 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$816.05
$741.86 × 110% = $816.05
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 26516 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
2,625
- Code
- 26516
- Physician work
- 7.14
- Practice expense
- 12.97
- Malpractice
- 1.37
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.14 | × 1.017 | 7.2614 |
| Practice expense | 12.97 | × 1.096 | 14.2151 |
| Malpractice | 1.37 | × 0.536 | 0.7343 |
| Total RVUs | 22.2108 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$741.86
Open 26516 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.14 | 1.017 |
| Practice expense | 12.97 | 1.096 |
| Malpractice | 1.37 | 0.536 |
(7.14 × 1.017 + 12.97 × 1.096 + 1.37 × 0.536) × $33.4009 = $741.86
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
26516 · 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 | $741.86 | RVU26D |
| 2026-07-01 | Not available in this setting | $741.86 | RVU26C |
| 2026-04-01 | Not available in this setting | $741.86 | RVU26B |
| 2026-01-01 | Not available in this setting | $741.86 | RVU26A |
| 2025-10-01 | Not available in this setting | $755.81 | RVU25D |
| 2025-07-01 | Not available in this setting | $755.81 | RVU25C |
| 2025-04-01 | Not available in this setting | $755.81 | RVU25B |
| 2025-01-01 | Not available in this setting | $755.81 | RVU25A |
26516 billing questions
Does internal fixation change the code?
No. Code 26516 covers MCP fusion with or without internal fixation. The operative report should still describe the joint and fusion performed.
How is this different from MCP arthroplasty?
Fusion permanently stabilizes the MCP joint. Codes 26530 and 26531 describe MCP arthroplasty, which is a different procedure involving joint reconstruction, with 26531 specifying an implant.
Can 26516 be reported for more than one fused joint?
Document each joint fused and verify the applicable code descriptor and reporting instructions for the complete operative work. Do not infer the unit count from the diagnosis alone.
When is modifier 50 used?
For bilateral performance, CMS pays code 26516 with modifier 50 at 150%. The documentation should support fusion on both sides.
Is postoperative care separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery 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.
2,62226502,,Hand tendon reconstruction,A,,7.13,13.68,NA,13.68,,1.50,22.31,22.31,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62326508,,Release thumb contracture,A,,6.03,12.13,NA,12.13,,1.04,19.20,19.20,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62426510,,Thumb tendon transfer,A,,5.46,12.28,NA,12.28,,1.05,18.79,18.79,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62526516,,Fusion of knuckle joint,A,,7.14,12.97,NA,12.97,,1.37,21.48,21.48,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62626517,,Fusion of knuckle joints,A,,8.85,14.58,NA,14.58,,1.88,25.31,25.31,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62726518,,Fusion of knuckle joints,A,,9.04,14.64,NA,14.64,,1.92,25.60,25.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62826520,,Release knuckle contracture,A,,5.33,13.73,NA,13.73,,1.02,20.08,20.08,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1901112,CA,61,REDDING,1.017,1.096,0.536