No office rate
Both codes describe interphalangeal joint arthroplasty. Choose 26536 when the procedure includes a prosthetic implant; 26535 is for arthroplasty without one.
On this page
CMS RVU26D · Effective 2026-10-01
26536 Finger joint arthroplasty Medicare reimbursement rates in Connecticut
Reports arthroplasty of a finger interphalangeal joint using a prosthetic implant, typically to address painful joint damage or deformity. Compare 26536 office and facility rates across CMS payment localities in Connecticut.
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 26536 in Connecticut?
Connecticut 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
$780.68
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 26536: Finger interphalangeal joint implant arthroplasty
Reports arthroplasty of a finger interphalangeal joint using a prosthetic implant, typically to address painful joint damage or deformity.
This procedure replaces or reconstructs the surfaces of a finger interphalangeal joint with a prosthetic implant. Hand surgeons, including orthopedic or plastic surgeons with hand expertise, may perform it for painful joint destruction, stiffness, or deformity, such as from arthritis or prior injury. The treated joint may be proximal or distal; the operative report should identify the joint and document the implant placement.
Choose this code when the interphalangeal joint arthroplasty includes a prosthetic implant, rather than the nonimplant procedure reported with 26535. Report it per treated joint, supported by the operative details; CMS does not apply the bilateral adjustment, so modifier 50 is inappropriate. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, CMS pays the highest-valued procedure in full and other procedures at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26536
- 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 RVU6.40 · 29%
- Practice expense (office) RVU14.27 · 65%
- Malpractice RVU1.22 · 6%
2.3K
Medicare services in 2024 · #2353 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.
26536 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
This code concerns metacarpophalangeal joint arthroplasty, not an interphalangeal joint. Select based on the joint actually treated.
No office rate
This code describes implant arthroplasty at a metacarpophalangeal joint. Code 26536 is for implant arthroplasty at a finger interphalangeal joint.
Compare 26536 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$780.68
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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 26536 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
2,633
- Code
- 26536
- Physician work
- 6.40
- Practice expense
- 14.27
- Malpractice
- 1.22
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.40 | × 1.020 | 6.5280 |
| Practice expense | 14.27 | × 1.077 | 15.3688 |
| Malpractice | 1.22 | × 1.210 | 1.4762 |
| Total RVUs | 23.3730 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$780.68
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.4 | 1.02 |
| Practice expense | 14.27 | 1.077 |
| Malpractice | 1.22 | 1.21 |
(6.4 × 1.02 + 14.27 × 1.077 + 1.22 × 1.21) × $33.4009 = $780.68
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.
26536 billing questions
When should 26536 be chosen over 26535?
Use 26536 when a prosthetic implant is placed during interphalangeal joint arthroplasty. Use 26535 when the arthroplasty is performed without a prosthetic implant.
Is the implant separately reported?
The implant placement is part of this arthroplasty service. The operative report should establish that a prosthetic implant was used.
How are multiple treated finger joints reported?
This code is reported per treated interphalangeal joint. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the listed CMS rules.
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.
2,63026530,,Revise knuckle joint,A,,6.71,7.27,NA,7.27,,1.28,15.26,15.26,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63126531,,Revise knuckle with implant,A,,7.93,8.19,NA,8.19,,1.49,17.61,17.61,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63226535,,Revise finger joint,A,,5.27,6.30,NA,6.30,,1.00,12.57,12.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63326536,,Revise/implant finger joint,A,,6.40,14.27,NA,14.27,,1.22,21.89,21.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63426540,,Repair hand joint,A,,6.44,12.66,NA,12.66,,1.24,20.34,20.34,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63526541,,Repair hand joint with graft,A,,8.59,13.70,NA,13.70,,1.65,23.94,23.94,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63626542,,Repair hand joint with graft,A,,6.78,12.78,NA,12.78,,1.30,20.86,20.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808