$228.00
26750 describes closed treatment of a distal phalanx fracture without manipulation. Choose 26765 when the fracture is surgically exposed and treated.
On this page
CMS RVU26D · Effective 2026-10-01
26765 Finger fracture Medicare reimbursement rates in Colorado
Reports surgical exposure and treatment of a finger or thumb distal phalanx fracture, with direct reduction and fixation when performed. Compare 26765 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 26765 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
$497.29
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 26765: Open treatment of distal phalanx fracture
Reports surgical exposure and treatment of a finger or thumb distal phalanx fracture, with direct reduction and fixation when performed.
An orthopedic or hand surgeon reports this service when the distal phalanx of a finger or thumb is surgically exposed and the fracture is treated directly. The work may include reducing the fracture and stabilizing it with fixation, such as a wire, when needed. It is used for operative fracture care in an operating room or another appropriate surgical setting; the code describes the treatment approach, not whether the fracture itself was open or closed.
Document the injured digit, distal phalanx fracture, operative exposure, reduction, and fixation performed. Report each treated fracture as supported by the record; internal fixation is part of the service when performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26765
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.71 · 39%
- Practice expense (office) RVU7.74 · 53%
- Malpractice RVU1.12 · 8%
1.3K
Medicare services in 2024 · #2754 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.
26765 compared with similar codes
Office rates for Colorado, from the same CMS release.
$393.60
26755 is closed treatment with manipulation; it does not describe open surgical treatment.
No office rate
26756 describes percutaneous skeletal fixation of a distal phalanx fracture. Use 26765 when treatment involves surgical exposure.
No office rate
26735 is for open treatment of a proximal or middle phalangeal shaft fracture, rather than a distal phalanx fracture.
Compare 26765 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
$497.29
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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 26765 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,686
- Code
- 26765
- Physician work
- 5.71
- Practice expense
- 7.74
- Malpractice
- 1.12
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.71 | × 1.012 | 5.7785 |
| Practice expense | 7.74 | × 1.064 | 8.2354 |
| Malpractice | 1.12 | × 0.781 | 0.8747 |
| Total RVUs | 14.8886 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$497.29
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.71 | 1.012 |
| Practice expense | 7.74 | 1.064 |
| Malpractice | 1.12 | 0.781 |
(5.71 × 1.012 + 7.74 × 1.064 + 1.12 × 0.781) × $33.4009 = $497.29
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.
26765 billing questions
How is this different from 26750 or 26755?
This code is for open surgical treatment of a distal phalanx fracture. Codes 26750 and 26755 describe closed treatment, without and with manipulation, respectively.
When would 26756 be a better fit?
Use 26756 for percutaneous skeletal fixation of a distal phalanx fracture. This code describes treatment through surgical exposure.
Is internal fixation separately reported?
Fixation performed as part of treating the fracture is included in this service. Document the method used and the fracture reduction.
What documentation supports reporting the code?
Record the finger or thumb and distal phalanx involved, the fracture treated, surgical exposure, reduction, and any fixation. Identify each fracture when reporting more than one.
Can modifier 50 be used for fractures on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
2,68326750,,Treat finger fracture each,A,,1.76,4.47,,4.11,,0.37,6.60,6.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68426755,,Treat finger fracture each,A,,3.15,7.58,,5.13,,0.68,11.41,8.96,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68526756,,Pin finger fracture each,A,,4.47,7.08,NA,7.08,,0.87,12.42,12.42,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68626765,,Treat finger fracture each,A,,5.71,7.74,NA,7.74,,1.12,14.57,14.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68726770,,Treat finger dislocation,A,,3.07,7.07,,5.45,,0.69,10.83,9.21,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68826775,,Treat finger dislocation,A,,3.80,8.59,,6.14,,0.76,13.15,10.70,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,68926776,,Pin finger dislocation,A,,4.87,7.22,NA,7.22,,0.93,13.02,13.02,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,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