Billing code 26045: Palmar releaseMedicare rate & RVUs in Delaware

Reports open division of a contracted palmar fascial cord, typically for Dupuytren disease causing restricted finger extension.

CMS RVU26DEffective Oct 1, 20261 payment locality913 Medicare services in 2024

CMS doesn’t publish an office rate for 26045 in Delaware.

—Office (non-facility)
$447.69Hospital 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 26045 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 26045 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 26045 covers

billing code 26045 represents an open palmar fasciotomy: the surgeon makes an incision over a contracted palmar fascial cord and divides it to release the contracture. The procedure is commonly performed for Dupuytren disease when a fixed contracture limits hand or finger extension. Hand, orthopedic, and plastic surgeons may perform it in an operating room or another surgical setting.

Choose this code when the documented work is open division of the contracted fascia, rather than percutaneous release or excision of diseased fascia. The operative note should identify the treated palm, the contracture and cord released, and the open technique. This major surgery has 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 the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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.

26045 in Delaware

26045 office and facility rates by payment locality
Payment localityOfficeFacility
DelawareUnavailable$447.69

How the 26045 rate is calculated

Each of 26045’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 · 26045

RVUs × geographic indexes × conversion factor

Work5.59

5.59 RVUs× 1.000 GPCI

Practice expense6.87

6.87 RVUs× 1.000 GPCI

Malpractice1.11

1.11 RVUs× 1.000 GPCI

Adjusted RVUs

13.5700

Conversion factor

$33.4009

Medicare rate

$453.25

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26045

26045 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26045

Palmar release

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
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 · 26045

Palmar release

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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 50 · payment effect

With and without the modifier

26045 without 50 · national facility

$453.25

Palmar release

26045-50 · Bilateral: 150%

$679.88

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

26045 compared with similar codes

Compare codes · National

4 codes, side by side

  • 26045

    Palmar release5.59 wRVU

    Not priced

  • 26040

    Palm contracture release3.37 wRVU

    Not priced

  • 26121

    Palmar fasciectomy7.54 wRVU

    Not priced

  • 26123

    Dupuytren release10.61 wRVU

    Not priced

How to choose

26040Palm contracture release
26040 is a percutaneous palmar release; 26045 is the open release. Select based on the operative approach documented.
26121Palmar fasciectomy
26121 describes excision of palmar fascia. 26045 describes open division of contracted fascia without fasciectomy.
26123Dupuytren release
26123 describes palmar fasciectomy with release extending into a digit, including the PIP joint. 26045 is an open palmar fasciotomy.

26045 billing questions

How does 26045 differ from 26040?

26045 describes open division of the palmar fascia. 26040 is used for percutaneous palmar release.

When is a fasciectomy code more appropriate?

Use a fasciectomy code when the surgeon removes diseased palmar fascia rather than simply dividing the contracted cord. The operative report should support the work performed.

Does the 90-day global include postoperative visits?

Related postoperative care for 90 days is included, as is the day-before preoperative visit.

How is bilateral 26045 reported?

Report bilateral treatment with modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.

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 26045PPRRVU2026_Oct_nonQPP.csv, line 2,536 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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