Billing code 26765: Finger fractureMedicare rate & RVUs in Florida
Reports surgical exposure and treatment of a finger or thumb distal phalanx fracture, with direct reduction and fixation when performed.
CMS doesn’t publish an office rate for 26765 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 26765 covers
An orthopedic or hand surgeon reports this service when the distal phalanx of a finger or thumb is surgically exposed and the fracture is treated directly. The work may include reducing the fracture and stabilizing it with fixation, such as a wire, when needed. It is used for operative fracture care in an operating room or another appropriate surgical setting; the code describes the treatment approach, not whether the fracture itself was open or closed.
Document the injured digit, distal phalanx fracture, operative exposure, reduction, and fixation performed. Report each treated fracture as supported by the record; internal fixation is part of the service when performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery for this service, and 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 26765 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 | $520.24 |
| Miami | Unavailable | $554.45 |
| Rest Of Florida | Unavailable | $494.09 |
How the 26765 rate is calculated
Each of 26765’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 · 26765
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.71Practice expense 7.74Malpractice 1.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26765
26765 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26765
Finger fracture
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 26765
Finger fracture
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
26765 without 51 · national facility
$486.65
Finger fracture
26765-51 · Second procedure: 50%
$243.33
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%).
26765 compared with similar codes
Compare codes
26765 vs 26750 vs 26755 vs 26756 vs 26735: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26750Finger fracture care
- 26750 describes closed treatment of a distal phalanx fracture without manipulation. Choose 26765 when the fracture is surgically exposed and treated.
- 26755Finger fracture care
- 26755 is closed treatment with manipulation; it does not describe open surgical treatment.
- 26756Fracture fixation
- 26756 describes percutaneous skeletal fixation of a distal phalanx fracture. Use 26765 when treatment involves surgical exposure.
- 26735Finger fracture repair
- 26735 is for open treatment of a proximal or middle phalangeal shaft fracture, rather than a distal phalanx fracture.
26765 billing questions
How is this different from 26750 or 26755?
This code is for open surgical treatment of a distal phalanx fracture. Codes 26750 and 26755 describe closed treatment, without and with manipulation, respectively.
When would 26756 be a better fit?
Use 26756 for percutaneous skeletal fixation of a distal phalanx fracture. This code describes treatment through surgical exposure.
Is internal fixation separately reported?
Fixation performed as part of treating the fracture is included in this service. Document the method used and the fracture reduction.
What documentation supports reporting the code?
Record the finger or thumb and distal phalanx involved, the fracture treated, surgical exposure, reduction, and any fixation. Identify each fracture when reporting more than one.
Can modifier 50 be used for fractures on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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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