$516.64
Use 26645 for closed treatment of a thumb carpometacarpal fracture-dislocation without manipulation; use 26665 when the fracture-dislocation is treated through an open approach.
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CMS RVU26D · Effective 2026-10-01
26665 Thumb fracture-dislocation repair Medicare reimbursement rates in Connecticut
Report this service for operative treatment of a fracture-dislocation at the thumb carpometacarpal joint, with fixation when performed. Compare 26665 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 26665 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
$613.46
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 26665: Open thumb carpometacarpal fracture-dislocation repair
Report this service for operative treatment of a fracture-dislocation at the thumb carpometacarpal joint, with fixation when performed.
This code covers open surgical treatment of a fracture-dislocation where the base of the thumb metacarpal is displaced at its joint with the trapezium. An orthopedic or hand surgeon typically exposes and reduces the joint and stabilizes the injury as needed, often in an operating room. The key distinction is a thumb carpometacarpal fracture-dislocation treated through an open approach, rather than an isolated thumb metacarpal fracture or a dislocation without fracture.
Choose the code based on the documented injury and operative approach. The operative report should identify the fracture-dislocation, the thumb carpometacarpal joint, the open reduction, and any fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 26665
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.74 · 45%
- Practice expense (office) RVU8.24 · 48%
- Malpractice RVU1.32 · 8%
90
Medicare services in 2024 · #4958 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.
26665 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
Code 26650 describes closed treatment with manipulation. Open operative treatment of the thumb carpometacarpal fracture-dislocation is reported with 26665.
$501.57
Code 26641 is for thumb carpometacarpal dislocation without a fracture. This code requires a fracture-dislocation treated openly.
No office rate
Code 26615 applies to open treatment of a metacarpal fracture; 26665 applies when the thumb carpometacarpal joint is involved in a fracture-dislocation.
Compare 26665 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
$613.46
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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 26665 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
2,666
- Code
- 26665
- Physician work
- 7.74
- Practice expense
- 8.24
- Malpractice
- 1.32
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.74 | × 1.020 | 7.8948 |
| Practice expense | 8.24 | × 1.077 | 8.8745 |
| Malpractice | 1.32 | × 1.210 | 1.5972 |
| Total RVUs | 18.3665 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$613.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.74 | 1.02 |
| Practice expense | 8.24 | 1.077 |
| Malpractice | 1.32 | 1.21 |
(7.74 × 1.02 + 8.24 × 1.077 + 1.32 × 1.21) × $33.4009 = $613.46
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.
26665 billing questions
When should this code be chosen instead of 26645 or 26650?
Use this code for open surgical treatment of a thumb carpometacarpal fracture-dislocation. Codes 26645 and 26650 describe closed treatment, distinguished by whether manipulation is performed.
How does this differ from open treatment of a thumb metacarpal fracture?
This code is for a fracture-dislocation involving the thumb carpometacarpal joint. Code 26615 is for open treatment of a metacarpal fracture and is not the choice for that joint fracture-dislocation.
Can fixation be reported separately?
Fixation performed as part of the open treatment is included in this service. The operative note should describe the reduction and any stabilization performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures or bilateral treatment handled?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are reduced by the standard multiple-procedure rule. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only with supporting documentation; team surgery is 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 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.
2,66326641,,Treat thumb dislocation,A,,4.03,9.16,,6.61,,0.86,14.05,11.50,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66426645,,Treat thumb fracture,A,,4.47,9.05,,6.30,,0.96,14.48,11.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66526650,,Treat thumb fracture,A,,5.22,7.83,NA,7.83,,1.04,14.09,14.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66626665,,Treat thumb fracture,A,,7.74,8.24,NA,8.24,,1.32,17.30,17.30,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66726670,,Treat hand dislocation,A,,3.73,8.28,,6.11,,0.86,12.87,10.70,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66826675,,Treat hand dislocation,A,,4.71,9.70,,6.82,,1.02,15.43,12.55,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66926676,,Pin hand dislocation,A,,5.60,7.97,NA,7.97,,1.07,14.64,14.64,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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