Billing code 26850: Knuckle fusionMedicare rate & RVUs in Delaware
Reports surgical fusion of a finger metacarpophalangeal joint for conditions such as painful arthritis, instability, or post-traumatic deformity.
CMS doesn’t publish an office rate for 26850 in Delaware.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 26850 covers
Code 26850 describes an operation to fuse a finger’s metacarpophalangeal (MCP) joint, the joint where the finger meets the hand. The surgeon prepares the joint surfaces and positions them for fusion; internal fixation may be used. Hand or orthopedic surgeons commonly perform the procedure in a hospital operating room or ambulatory surgery center for a painful, unstable, or deformed MCP joint, including after trauma.
Select this code for MCP fusion without autogenous bone graft; when autogenous graft is used, consider 26852. The operative report should identify the joint and side, the condition treated, and whether graft or fixation was used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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.
26850 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $697.98 |
How the 26850 rate is calculated
Each of 26850’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 · 26850
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.96Practice expense 12.87Malpractice 1.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26850
26850 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26850
Knuckle fusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26850
Knuckle fusion
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26850 without 51 · national facility
$706.43
Knuckle fusion
26850-51 · Second procedure: 50%
$353.22
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26850 compared with similar codes
Compare codes
26850 vs 26852 vs 26860 vs 26843 vs 26841: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26852Knuckle fusion
- Both describe MCP fusion, but 26852 includes autogenous bone graft. Internal fixation alone does not call for the graft code.
- 26860Finger joint fusion
- Use 26860 for fusion of a finger interphalangeal joint, not the MCP joint at the base of the finger.
- 26843Hand joint fusion
- Code 26843 concerns fusion of a non-thumb carpometacarpal joint in the hand; 26850 concerns a finger MCP joint.
- 26841Thumb fusion
- Code 26841 is for the thumb carpometacarpal joint. It is not the code for fusion of a finger MCP joint.
26850 billing questions
When should 26852 be reported instead?
Use 26852 when the MCP fusion includes autogenous bone graft. Internal fixation by itself does not distinguish 26852 from 26850.
Is internal fixation included in 26850?
Yes. The code covers MCP fusion with or without internal fixation.
Does 26850 describe a finger MCP joint or an interphalangeal joint?
It describes the joint at the base of a finger, where the finger meets the hand. Fusion of a finger interphalangeal joint is in the 26860 code family.
Should modifier 50 be used for bilateral MCP fusions?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
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