No office rate
Both address MCP joint arthroplasty, but 26531 includes implant placement; 26530 is for arthroplasty without an implant.
On this page
CMS RVU26D · Effective 2026-10-01
26531 Knuckle arthroplasty Medicare reimbursement rates in Hawaii
Reports implant arthroplasty of a metacarpophalangeal joint to address painful joint destruction or deformity while preserving finger motion. Compare 26531 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26531 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$604.71
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Hand surgery
About 26531: Metacarpophalangeal joint implant arthroplasty
Reports implant arthroplasty of a metacarpophalangeal joint to address painful joint destruction or deformity while preserving finger motion.
A hand surgeon removes damaged joint surfaces at a metacarpophalangeal (MCP) joint and places an implant to improve alignment and preserve motion. Typical cases include painful MCP destruction and deformity from rheumatoid arthritis, or joint damage from other causes. The procedure is generally performed in an operating room, with the specific finger and joint identified in the operative report.
Report this code when the operation includes an implant at the MCP joint; distinguish it from MCP arthroplasty without an implant and implant arthroplasty at a finger interphalangeal joint. Documentation should establish the treated joint, the underlying problem, and implant placement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 26531
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.93 · 45%
- Practice expense (office) RVU8.19 · 47%
- Malpractice RVU1.49 · 8%
3.5K
Medicare services in 2024 · #2080 by national volume
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.
26531 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
Both involve implant arthroplasty, but 26536 is for a finger interphalangeal joint. Use 26531 for an MCP joint.
No office rate
This code describes fusion of an MCP joint. Choose it when the operation fuses the joint, not when an implant arthroplasty is performed.
Compare 26531 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$604.71
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 26531 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,631
- Code
- 26531
- Physician work
- 7.93
- Practice expense
- 8.19
- Malpractice
- 1.49
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.93 | × 1.000 | 7.9300 |
| Practice expense | 8.19 | × 1.137 | 9.3120 |
| Malpractice | 1.49 | × 0.579 | 0.8627 |
| Total RVUs | 18.1047 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$604.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.93 | 1 |
| Practice expense | 8.19 | 1.137 |
| Malpractice | 1.49 | 0.579 |
(7.93 × 1 + 8.19 × 1.137 + 1.49 × 0.579) × $33.4009 = $604.71
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
26531 billing questions
How does this differ from 26530?
Use 26531 when an implant is placed during MCP joint arthroplasty. Code 26530 describes MCP arthroplasty without an implant.
Can this code be used for an implant at a finger joint?
No. This code is for a metacarpophalangeal joint. Code 26536 describes implant arthroplasty at an interphalangeal joint.
Should modifier 50 be reported when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Follow the applicable reporting instructions for the procedures performed on each hand.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,62826520,,Release knuckle contracture,A,,5.33,13.73,NA,13.73,,1.02,20.08,20.08,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62926525,,Release finger contracture,A,,5.36,13.87,NA,13.87,,1.04,20.27,20.27,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63026530,,Revise knuckle joint,A,,6.71,7.27,NA,7.27,,1.28,15.26,15.26,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63126531,,Revise knuckle with implant,A,,7.93,8.19,NA,8.19,,1.49,17.61,17.61,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63226535,,Revise finger joint,A,,5.27,6.30,NA,6.30,,1.00,12.57,12.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63326536,,Revise/implant finger joint,A,,6.40,14.27,NA,14.27,,1.22,21.89,21.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63426540,,Repair hand joint,A,,6.44,12.66,NA,12.66,,1.24,20.34,20.34,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014