Billing code 26705: Knuckle reductionMedicare rate & RVUs in Alaska

Reports closed reduction of a single metacarpophalangeal joint dislocation when manipulation is performed under anesthesia, rather than simple positioning or fixation.

CMS RVU26DEffective Oct 1, 20261 payment locality69 Medicare services in 2024

Medicare pays $566.84 for 26705 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$566.84Office (non-facility)
$468.66Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 26705 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 26705 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 26705 covers

This service is a closed reduction of a dislocated metacarpophalangeal (MCP) joint—the knuckle where a finger meets the hand. The clinician manipulates the joint back into alignment without opening the joint or using percutaneous pins. It is typically performed by an orthopedic or hand surgeon, sometimes in an emergency or procedure setting, when reduction requires anesthesia. The code applies to one MCP joint; a dislocation at a finger’s interphalangeal joint is a different anatomic service.

The record should identify the affected MCP joint, document the dislocation, the manipulative reduction, and the use of anesthesia. This is a major procedure with 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 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented 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.

26705 in Alaska*

26705 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$566.84$468.66

How the 26705 rate is calculated

Each of 26705’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 · 26705

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.27Practice expense 9.45Malpractice 0.91

14.6300 adjusted RVUs×$33.4009 conversion factor=$488.66

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 26705

26705 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26705

Knuckle reduction

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 26705

Knuckle reduction

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.

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

26705 without 51 · national office

$488.66

Knuckle reduction

26705-51 · Second procedure: 50%

$244.33

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

26705 compared with similar codes

Compare codes

26705 vs 26700 vs 26706 vs 26715 vs 26775: national Medicare rates

Swap in your local Medicare rate.

  • 26705
    Knuckle reduction · 4.27 wRVU
    $488.66
  • 26700
    MCP dislocation · 3.73 wRVU
    $406.82−$81.84
  • 26706
    Knuckle dislocation · 5.18 wRVU
    —
  • 26715
    Knuckle dislocation · 6.85 wRVU
    —
  • 26775
    Finger dislocation · 3.8 wRVU
    $439.22−$49.44

How to choose

26700MCP dislocation
Choose 26705 for a single MCP dislocation requiring manipulative reduction under anesthesia; 26700 represents closed treatment without manipulation.
26706Knuckle dislocation
26706 is for percutaneous skeletal fixation of an MCP dislocation. Use 26705 when the closed reduction does not include percutaneous fixation.
26715Knuckle dislocation
26715 describes open treatment of an MCP dislocation. 26705 is for closed manipulative reduction.
26775Finger dislocation
26775 concerns an interphalangeal joint dislocation treated with manipulation requiring anesthesia; 26705 concerns the MCP joint.

26705 billing questions

How does this differ from 26700?

26705 is for a single MCP dislocation reduced with manipulation requiring anesthesia. 26700 is the related code for closed treatment without manipulation.

When should 26706 be considered instead?

Use 26706 when percutaneous skeletal fixation is performed for the MCP dislocation. This code describes closed manipulative reduction without percutaneous fixation.

Can modifier 50 be used for dislocations on both hands?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. 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 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 26705PPRRVU2026_Oct_nonQPP.csv, line 2,673 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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