Billing code 26536: Finger joint arthroplastyMedicare rate & RVUs in Florida
Reports arthroplasty of a finger interphalangeal joint using a prosthetic implant, typically to address painful joint damage or deformity.
CMS doesn’t publish an office rate for 26536 in Florida.
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 26536 covers
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.
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.
Where 26536 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $770.27 |
| Miami | Unavailable | $812.99 |
| Rest Of Florida | Unavailable | $730.67 |
How the 26536 rate is calculated
Each of 26536’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 · 26536
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.40Practice expense 14.27Malpractice 1.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26536
26536 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26536
Finger joint arthroplasty
| 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 · 26536
Finger joint arthroplasty
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
26536 without 51 · national facility
$731.15
Finger joint arthroplasty
26536-51 · Second procedure: 50%
$365.58
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%).
26536 compared with similar codes
Compare codes
26536 vs 26535 vs 26530 vs 26531: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26535Finger joint surgery
- Both codes describe interphalangeal joint arthroplasty. Choose 26536 when the procedure includes a prosthetic implant; 26535 is for arthroplasty without one.
- 26530Knuckle arthroplasty
- This code concerns metacarpophalangeal joint arthroplasty, not an interphalangeal joint. Select based on the joint actually treated.
- 26531Knuckle arthroplasty
- This code describes implant arthroplasty at a metacarpophalangeal joint. Code 26536 is for implant arthroplasty at a finger interphalangeal joint.
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 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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