No office rate
Both describe open treatment of CMC dislocations. Choose 26685 for a single dislocation and this code for multiple dislocations.
On this page
CMS RVU26D · Effective 2026-10-01
26686 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$596.77
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 26686: Open treatment of multiple hand joint dislocations
Report open operative treatment of multiple carpometacarpal dislocations when the surgeon exposes and reduces the affected hand joints, with fixation when performed.
This service covers open treatment of multiple carpometacarpal (CMC) joint dislocations in the hand. An orthopedic or hand surgeon exposes the involved joints, restores alignment, and may stabilize them with internal fixation. It is generally performed in a facility operating room for injuries requiring open reduction, such as multiple unstable CMC dislocations. The code distinguishes treatment of multiple joints from open treatment of a single CMC dislocation and from closed or percutaneous approaches.
Report the code when the operative record supports open treatment of multiple CMC dislocations; document the affected joints, approach, reduction, and any fixation. 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 multiple procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 26686
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.97 · 45%
- Practice expense (office) RVU8.08 · 46%
- Malpractice RVU1.69 · 10%
67
Medicare services in 2024 · #5170 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.
26686 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
26676 describes percutaneous skeletal fixation of a single CMC dislocation. This code is for open treatment of multiple dislocations.
$533.35
26675 is closed treatment with manipulation. This code is for open treatment of multiple CMC dislocations.
$487.61
26641 addresses a thumb CMC dislocation. This code covers open treatment of multiple CMC dislocations elsewhere in the hand.
The same code, a different location
How does Modesto compare?
26686 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 · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Merced
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Napa
California · 26686
Office
Unavailable
Facility
$667.35
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 26686
Office
Unavailable
Facility
$627.82
No comparable office rate is available.
Redding
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Rest Of California
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 26686
Office
Unavailable
Facility
$614.93
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 26686
Office
Unavailable
Facility
$619.91
No comparable office rate is available.
Salinas
California · 26686
Office
Unavailable
Facility
$617.50
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 26686
Office
Unavailable
Facility
$627.56
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 26686
Office
Unavailable
Facility
$697.93
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 26686
Office
Unavailable
Facility
$696.01
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 26686
Office
Unavailable
Facility
$714.91
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 26686
Office
Unavailable
Facility
$707.06
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 26686
Office
Unavailable
Facility
$608.38
No comparable office rate is available.
Santa Cruz-Watsonville
California · 26686
Office
Unavailable
Facility
$629.95
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 26686
Office
Unavailable
Facility
$618.59
No comparable office rate is available.
Santa Rosa-Petaluma
California · 26686
Office
Unavailable
Facility
$635.86
No comparable office rate is available.
Stockton
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Vallejo
California · 26686
Office
Unavailable
Facility
$664.59
No comparable office rate is available.
Visalia
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Yuba City
California · 26686
Office
Unavailable
Facility
$596.77
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 26686
Office
Unavailable
Facility
$661.32
No comparable office rate is available.
Miami
Florida · 26686
Office
Unavailable
Facility
$689.91
No comparable office rate is available.
Chicago
Illinois · 26686
Office
Unavailable
Facility
$668.84
No comparable office rate is available.
Manhattan
New York · 26686
Office
Unavailable
Facility
$686.37
No comparable office rate is available.
Alaska*
Alaska · 26686
Office
Unavailable
Facility
$717.83
No comparable office rate is available.
Alabama
Alabama · 26686
Office
Unavailable
Facility
$534.30
No comparable office rate is available.
Arkansas
Arkansas · 26686
Office
Unavailable
Facility
$527.10
No comparable office rate is available.
Arizona
Arizona · 26686
Office
Unavailable
Facility
$576.04
No comparable office rate is available.
Colorado
Colorado · 26686
Office
Unavailable
Facility
$600.64
No comparable office rate is available.
Connecticut
Connecticut · 26686
Office
Unavailable
Facility
$630.49
No comparable office rate is available.
Delaware
Delaware · 26686
Office
Unavailable
Facility
$584.92
No comparable office rate is available.
Fort Lauderdale
Florida · 26686
Office
Unavailable
Facility
$641.65
No comparable office rate is available.
Rest Of Florida
Florida · 26686
Office
Unavailable
Facility
$609.05
No comparable office rate is available.
Atlanta
Georgia · 26686
Office
Unavailable
Facility
$608.99
No comparable office rate is available.
Rest Of Georgia
Georgia · 26686
Office
Unavailable
Facility
$574.22
No comparable office rate is available.
Hawaii, Guam
Hawaii · 26686
Office
Unavailable
Facility
$605.74
No comparable office rate is available.
Iowa
Iowa · 26686
Office
Unavailable
Facility
$535.55
No comparable office rate is available.
Idaho
Idaho · 26686
Office
Unavailable
Facility
$541.19
No comparable office rate is available.
East St. Louis
Illinois · 26686
Office
Unavailable
Facility
$628.18
No comparable office rate is available.
Rest Of Illinois
Illinois · 26686
Office
Unavailable
Facility
$600.83
No comparable office rate is available.
Suburban Chicago
Illinois · 26686
Office
Unavailable
Facility
$645.26
No comparable office rate is available.
Indiana
Indiana · 26686
Office
Unavailable
Facility
$543.82
No comparable office rate is available.
Kansas
Kansas · 26686
Office
Unavailable
Facility
$538.63
No comparable office rate is available.
Kentucky
Kentucky · 26686
Office
Unavailable
Facility
$557.78
No comparable office rate is available.
New Orleans
Louisiana · 26686
Office
Unavailable
Facility
$584.29
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 26686
Office
Unavailable
Facility
$559.13
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 26686
Office
Unavailable
Facility
$649.59
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 26686
Office
Unavailable
Facility
$599.64
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 26686
Office
Unavailable
Facility
$629.87
No comparable office rate is available.
Rest Of Maryland
Maryland · 26686
Office
Unavailable
Facility
$593.80
No comparable office rate is available.
Rest Of Maine
Maine · 26686
Office
Unavailable
Facility
$549.60
No comparable office rate is available.
Southern Maine
Maine · 26686
Office
Unavailable
Facility
$569.27
No comparable office rate is available.
Detroit
Michigan · 26686
Office
Unavailable
Facility
$621.81
No comparable office rate is available.
Rest Of Michigan
Michigan · 26686
Office
Unavailable
Facility
$576.33
No comparable office rate is available.
Minnesota
Minnesota · 26686
Office
Unavailable
Facility
$560.62
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 26686
Office
Unavailable
Facility
$574.77
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 26686
Office
Unavailable
Facility
$579.69
No comparable office rate is available.
Rest Of Missouri
Missouri · 26686
Office
Unavailable
Facility
$553.82
No comparable office rate is available.
Mississippi
Mississippi · 26686
Office
Unavailable
Facility
$540.29
No comparable office rate is available.
Montana**
Montana · 26686
Office
Unavailable
Facility
$592.42
No comparable office rate is available.
North Carolina
North Carolina · 26686
Office
Unavailable
Facility
$554.07
No comparable office rate is available.
North Dakota**
North Dakota · 26686
Office
Unavailable
Facility
$559.00
No comparable office rate is available.
Nebraska
Nebraska · 26686
Office
Unavailable
Facility
$536.64
No comparable office rate is available.
New Hampshire
New Hampshire · 26686
Office
Unavailable
Facility
$596.54
No comparable office rate is available.
Northern Nj
New Jersey · 26686
Office
Unavailable
Facility
$656.32
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 26686
Office
Unavailable
Facility
$633.48
No comparable office rate is available.
New Mexico
New Mexico · 26686
Office
Unavailable
Facility
$581.48
No comparable office rate is available.
Nevada**
Nevada · 26686
Office
Unavailable
Facility
$583.38
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 26686
Office
Unavailable
Facility
$708.95
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 26686
Office
Unavailable
Facility
$642.00
No comparable office rate is available.
Queens
New York · 26686
Office
Unavailable
Facility
$683.64
No comparable office rate is available.
Rest Of New York
New York · 26686
Office
Unavailable
Facility
$562.27
No comparable office rate is available.
Ohio
Ohio · 26686
Office
Unavailable
Facility
$569.50
No comparable office rate is available.
Oklahoma
Oklahoma · 26686
Office
Unavailable
Facility
$551.07
No comparable office rate is available.
Portland
Oregon · 26686
Office
Unavailable
Facility
$612.30
No comparable office rate is available.
Rest Of Oregon
Oregon · 26686
Office
Unavailable
Facility
$574.69
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 26686
Office
Unavailable
Facility
$619.28
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 26686
Office
Unavailable
Facility
$567.30
No comparable office rate is available.
Puerto Rico
Puerto Rico · 26686
Office
Unavailable
Facility
$594.65
No comparable office rate is available.
Rhode Island
Rhode Island · 26686
Office
Unavailable
Facility
$600.40
No comparable office rate is available.
South Carolina
South Carolina · 26686
Office
Unavailable
Facility
$563.55
No comparable office rate is available.
South Dakota**
South Dakota · 26686
Office
Unavailable
Facility
$555.05
No comparable office rate is available.
Tennessee
Tennessee · 26686
Office
Unavailable
Facility
$541.84
No comparable office rate is available.
Austin
Texas · 26686
Office
Unavailable
Facility
$602.28
No comparable office rate is available.
Beaumont
Texas · 26686
Office
Unavailable
Facility
$564.24
No comparable office rate is available.
Brazoria
Texas · 26686
Office
Unavailable
Facility
$579.81
No comparable office rate is available.
Dallas
Texas · 26686
Office
Unavailable
Facility
$585.83
No comparable office rate is available.
Fort Worth
Texas · 26686
Office
Unavailable
Facility
$583.87
No comparable office rate is available.
Galveston
Texas · 26686
Office
Unavailable
Facility
$583.06
No comparable office rate is available.
Houston
Texas · 26686
Office
Unavailable
Facility
$614.00
No comparable office rate is available.
Rest Of Texas
Texas · 26686
Office
Unavailable
Facility
$573.29
No comparable office rate is available.
Utah
Utah · 26686
Office
Unavailable
Facility
$570.58
No comparable office rate is available.
Virginia
Virginia · 26686
Office
Unavailable
Facility
$571.35
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 26686
Office
Unavailable
Facility
$594.65
No comparable office rate is available.
Vermont
Vermont · 26686
Office
Unavailable
Facility
$561.95
No comparable office rate is available.
Rest Of Washington
Washington · 26686
Office
Unavailable
Facility
$596.81
No comparable office rate is available.
Seattle (King Cnty)
Washington · 26686
Office
Unavailable
Facility
$656.77
No comparable office rate is available.
Wisconsin
Wisconsin · 26686
Office
Unavailable
Facility
$542.14
No comparable office rate is available.
West Virginia
West Virginia · 26686
Office
Unavailable
Facility
$581.51
No comparable office rate is available.
Wyoming**
Wyoming · 26686
Office
Unavailable
Facility
$577.86
No comparable office rate is available.
See how rates vary across the country
26686 · 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 26686 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$656.45
$596.77 × 110% = $656.45
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 26686 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
2,671
- Code
- 26686
- Physician work
- 7.97
- Practice expense
- 8.08
- Malpractice
- 1.69
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.97 | × 1.017 | 8.1055 |
| Practice expense | 8.08 | × 1.096 | 8.8557 |
| Malpractice | 1.69 | × 0.536 | 0.9058 |
| Total RVUs | 17.8670 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$596.77
Open 26686 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.97 | 1.017 |
| Practice expense | 8.08 | 1.096 |
| Malpractice | 1.69 | 0.536 |
(7.97 × 1.017 + 8.08 × 1.096 + 1.69 × 0.536) × $33.4009 = $596.77
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
26686 · 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 | $596.77 | RVU26D |
| 2026-07-01 | Not available in this setting | $596.77 | RVU26C |
| 2026-04-01 | Not available in this setting | $596.77 | RVU26B |
| 2026-01-01 | Not available in this setting | $596.77 | RVU26A |
| 2025-10-01 | Not available in this setting | $628.26 | RVU25D |
| 2025-07-01 | Not available in this setting | $628.26 | RVU25C |
| 2025-04-01 | Not available in this setting | $628.26 | RVU25B |
| 2025-01-01 | Not available in this setting | $628.26 | RVU25A |
26686 billing questions
When should this code be chosen instead of 26685?
Use this code for open treatment of multiple CMC dislocations. Code 26685 is for open treatment of a single CMC dislocation.
How does this differ from closed treatment codes?
This code describes open operative treatment. Codes 26670 and 26675 describe closed treatment, without and with manipulation, respectively.
Does internal fixation have to be performed?
No. Fixation may be used, but the code covers open treatment whether or not internal fixation is performed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are 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 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.
2,66826675,,Treat hand dislocation,A,,4.71,9.70,,6.82,,1.02,15.43,12.55,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66926676,,Pin hand dislocation,A,,5.60,7.97,NA,7.97,,1.07,14.64,14.64,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67026685,,Treat hand dislocation,A,,6.89,7.95,NA,7.95,,1.19,16.03,16.03,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67126686,,Treat hand dislocation,A,,7.97,8.08,NA,8.08,,1.69,17.74,17.74,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67226700,,Treat knuckle dislocation,A,,3.73,7.62,,5.87,,0.83,12.18,10.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67326705,,Treat knuckle dislocation,A,,4.27,9.45,,6.69,,0.91,14.63,11.87,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67426706,,Pin knuckle dislocation,A,,5.18,6.45,NA,6.45,,0.89,12.52,12.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,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