$424.27
Use 26670 for a non-thumb carpometacarpal dislocation treated without manipulation. This code includes manipulation and percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
26676 Hand dislocation Medicare reimbursement rates in Delaware
Closed reduction and percutaneous pin stabilization of a carpometacarpal dislocation involving a finger ray, reported when manipulation and skeletal fixation are performed. Compare 26676 office and facility rates across CMS payment localities in Delaware.
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 26676 in Delaware?
Delaware 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
$483.12
1 of 1 localities have a supported rate.
Payment area: Delaware
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 26676: Percutaneous fixation of hand CMC dislocation
Closed reduction and percutaneous pin stabilization of a carpometacarpal dislocation involving a finger ray, reported when manipulation and skeletal fixation are performed.
This service covers closed reduction of a carpometacarpal joint dislocation in the hand, excluding the thumb, followed by percutaneous placement of pins to hold the joint in position. The surgeon manipulates the displaced metacarpal into alignment without opening the joint and places fixation through the skin. Orthopedic and hand surgeons typically perform this treatment in a hospital or ambulatory surgery setting, often after an acute hand injury.
Report this code when the documentation supports a non-thumb carpometacarpal dislocation treated with manipulation and percutaneous skeletal fixation; a reduction without pins or an open approach points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26676
- 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 RVU5.60 · 38%
- Practice expense (office) RVU7.97 · 54%
- Malpractice RVU1.07 · 7%
162
Medicare services in 2024 · #4500 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.
26676 compared with similar codes
Office rates for Delaware, from the same CMS release.
$508.83
Use 26675 when manipulation is performed without percutaneous skeletal fixation. This code includes both manipulation and pin stabilization.
No office rate
Use 26685 when the non-thumb carpometacarpal dislocation is treated through an open approach; this code describes closed reduction with percutaneous fixation.
$463.38
Code 26641 concerns a thumb carpometacarpal dislocation. This code is for a carpometacarpal dislocation other than the thumb.
Compare 26676 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
Delaware →
Office / nonfacility
Unavailable
Facility
$483.12
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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 26676 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,669
- Code
- 26676
- Physician work
- 5.60
- Practice expense
- 7.97
- Malpractice
- 1.07
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.60 | × 1.005 | 5.6280 |
| Practice expense | 7.97 | × 0.988 | 7.8744 |
| Malpractice | 1.07 | × 0.899 | 0.9619 |
| Total RVUs | 14.4643 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$483.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.6 | 1.005 |
| Practice expense | 7.97 | 0.988 |
| Malpractice | 1.07 | 0.899 |
(5.6 × 1.005 + 7.97 × 0.988 + 1.07 × 0.899) × $33.4009 = $483.12
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.
26676 billing questions
When is this code selected instead of 26675?
Use this code when the non-thumb carpometacarpal dislocation is manipulated and stabilized with percutaneous skeletal fixation. Code 26675 describes manipulation without that pin fixation.
Can the pin placement be reported separately?
No. The percutaneous skeletal fixation is part of this service when performed as the documented stabilization of the reduced dislocation.
Does modifier 50 apply if both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What documentation supports reporting this code?
Document the affected non-thumb carpometacarpal joint, the dislocation, manipulation to restore alignment, and percutaneous skeletal fixation used to maintain the reduction.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
2,66626665,,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
2,67026685,,Treat hand dislocation,A,,6.89,7.95,NA,7.95,,1.19,16.03,16.03,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67126686,,Treat hand dislocation,A,,7.97,8.08,NA,8.08,,1.69,17.74,17.74,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67226700,,Treat knuckle dislocation,A,,3.73,7.62,,5.87,,0.83,12.18,10.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503