Billing code 26320: Implant removalMedicare rate & RVUs in Guam
Reports operative removal of an implanted device from the hand, such as fixation hardware that is painful, prominent, or no longer needed.
CMS doesn’t publish an office rate for 26320 in Guam.
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 26320 covers
A hand surgeon or orthopedic surgeon uses this service to remove an implanted device from the hand, often after a fracture has healed or when hardware causes pain, prominence, or other problems. Examples include a buried wire, pin, screw, or plate. Removal involves operative access to the implant; it is not simply removal of an external splint or dressing. The procedure may take place in a hospital or ambulatory surgery setting.
Select the code for an implant in the hand, rather than a general implant-removal code for another site or a foreign-body removal code. The operative report should identify the implant, its hand location, and the work performed to remove it. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one 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; 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.
26320 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $351.10 |
How the 26320 rate is calculated
Each of 26320’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 · 26320
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.00Practice expense 5.33Malpractice 0.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26320
26320 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26320
Implant removal
| 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 · 26320
Implant removal
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
26320 without 51 · national facility
$337.68
Implant removal
26320-51 · Second procedure: 50%
$168.84
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%).
26320 compared with similar codes
Compare codes
26320 vs 20670 vs 20680 vs 20525: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20670Implant removal
- 20670 addresses superficial implant removal in applicable circumstances. For an implanted device in the hand, consider the hand-specific 26320 code.
- 20680Implant removal
- 20680 is a general code for deep implant removal. 26320 identifies removal of an implant from the hand.
- 20525Foreign body removal
- 20525 concerns removal of a deep foreign body, not an implanted device such as fixation hardware.
26320 billing questions
When should I report 26320 instead of a general implant-removal code?
Use 26320 for operative removal of an implant located in the hand. General implant-removal codes are relevant to other sites or circumstances, such as a superficial implant addressed by 20670 or a deep implant addressed by 20680.
Is removal of a retained foreign body the same service?
No. An implanted device, such as fixation hardware, is different from an unintentional retained foreign body; code 20525 may describe removal of a deep foreign body in the appropriate circumstances.
Should modifier 50 be appended when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so 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.
Can an assistant surgeon or co-surgeon be billed?
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 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
Fee sheets
Put 26320 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →