Billing code 26591: Hand muscle repairMedicare rate & RVUs in Alaska
Reports operative repair of injured intrinsic hand muscles, such as interossei or lumbricals, when the procedure restores the muscle’s continuity or function.
CMS doesn’t publish an office rate for 26591 in Alaska.
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 9 sections
What 26591 covers
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.
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 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $561.63 |
How the 26591 rate is calculated
Each of 26591’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 · 26591
RVUs × geographic indexes × conversion factor
Work3.30
3.30 RVUs× 1.000 GPCI
Practice expense10.82
10.82 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
14.7400
Conversion factor
$33.4009
Medicare rate
$492.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26591
26591 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26591
Hand muscle repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26591
Hand muscle repair
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26591 without 51 · national facility
$492.33
Hand muscle repair
26591-51 · Second procedure: 50%
$246.17
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%).
26591 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26593Muscle release
- Choose 26591 for repair of an intrinsic hand muscle. Choose 26593 when the procedure releases intrinsic muscle tightness.
- 26540Ligament repair
- 26540 addresses repair of a hand joint. This code addresses repair of intrinsic muscle tissue, not the joint.
- 26541Ligament repair
- 26541 describes hand-joint repair with graft; 26591 is for intrinsic muscle repair and does not describe a grafted joint repair.
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 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
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