No office rate
Choose 26591 for repair of an intrinsic hand muscle. Choose 26593 when the procedure releases intrinsic muscle tightness.
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CMS RVU26D · Effective 2026-10-01
26591 Hand muscle repair Medicare reimbursement rates in Colorado
Reports operative repair of injured intrinsic hand muscles, such as interossei or lumbricals, when the procedure restores the muscle’s continuity or function. Compare 26591 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 26591 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$512.25
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Colorado, 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.
Compare 26591 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$512.25
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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 Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,655
- Code
- 26591
- Physician work
- 3.30
- Practice expense
- 10.82
- Malpractice
- 0.62
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.30 | × 1.012 | 3.3396 |
| Practice expense | 10.82 | × 1.064 | 11.5125 |
| Malpractice | 0.62 | × 0.781 | 0.4842 |
| Total RVUs | 15.3363 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$512.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.3 | 1.012 |
| Practice expense | 10.82 | 1.064 |
| Malpractice | 0.62 | 0.781 |
(3.3 × 1.012 + 10.82 × 1.064 + 0.62 × 0.781) × $33.4009 = $512.25
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.
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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899