Billing code 26863: Finger joint fusionMedicare rate & RVUs in Florida
Reports grafted fusion of each additional finger interphalangeal joint performed with a primary joint fusion, when the operative documentation supports the extra joint.
CMS doesn’t publish an office rate for 26863 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 26863 covers
This add-on represents fusion of an additional interphalangeal joint of a finger using autogenous bone graft. Hand or orthopedic surgeons may perform it when more than one finger joint requires stabilization, such as for painful joint disease or deformity. The procedure is generally performed in an operating room; the operative report should identify the joints fused and document graft use.
Report 26863 with the primary grafted joint-fusion procedure, 26862, for each additional joint treated. The operative note should distinguish the primary joint from each additional joint and support the number of units billed. This code is an add-on, not a stand-alone service, and payment falls within the primary procedure’s global period.
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 26863 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 | $211.16 |
| Miami | Unavailable | $229.18 |
| Rest Of Florida | Unavailable | $201.64 |
How the 26863 rate is calculated
Each of 26863’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 · 26863
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.79Practice expense 1.25Malpractice 0.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26863
The CMS indicators that decide how 26863 is paid alongside other services.
CMS payment indicators · 26863
Finger joint fusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
26863 without 80 · national facility
$191.72
Finger joint fusion
26863-80 · Assistant: 16%
$30.68
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
26863 compared with similar codes
Compare codes
26863 vs 26862 vs 26861 vs 26860: national Medicare rates
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How to choose
- 26862Finger fusion
- 26862 represents the primary grafted interphalangeal joint fusion. Use 26863 for each additional grafted joint in the same operative service.
- 26861Finger joint fusion
- 26861 represents an additional interphalangeal joint fusion without autogenous graft; 26863 is for an additional joint treated with graft.
- 26860Finger joint fusion
- 26860 is a primary interphalangeal joint fusion without the graft distinction. It does not represent an additional grafted joint.
26863 billing questions
Which primary code must accompany 26863?
Report 26863 with 26862, the primary finger interphalangeal joint fusion code with autogenous graft. It is not reported by itself.
How many units should be reported?
Report one unit for each additional interphalangeal joint fused beyond the primary joint. The operative note should identify each joint treated.
When is 26861 a better fit?
Use 26861 for an additional interphalangeal joint fusion when the service does not include autogenous bone graft. Code 26863 is the grafted additional-joint counterpart.
Is graft harvesting separately represented by 26863?
The documentation should establish that autogenous graft was used for the additional joint. Report 26863 with 26862; payment is within the primary procedure’s global period.
What documentation supports reporting an additional joint?
The operative report should name the primary fused joint and each additional interphalangeal joint, describe the fusion performed, and support autogenous graft use.
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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