Billing code 26517: Knuckle fusionMedicare rate & RVUs in Illinois
Reports surgical fusion of a metacarpophalangeal knuckle joint to stabilize a painful, deformed, or unstable joint in the hand.
CMS doesn’t publish an office rate for 26517 in Illinois.
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 26517 covers
A hand surgeon surgically fuses a metacarpophalangeal (MCP) joint, the knuckle where a finger meets the hand, to create a stable joint by eliminating motion there. The procedure may be considered for severe joint disease, deformity, or instability when preserving motion is not the goal. It is performed in an operating room, commonly in a hospital or ambulatory surgery center. The operative report should identify the finger and MCP joint treated and describe the fusion performed.
Report this code for the MCP fusion work documented in the operative note; distinguish it from procedures on the finger’s interphalangeal joints and from joint reconstruction or contracture release. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures reported with modifier 50, CMS pays 150%. An assistant at surgery may be paid; 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 26517 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $931.20 |
| East St. Louis | Unavailable | $870.09 |
| Rest Of Illinois | Unavailable | $838.36 |
| Suburban Chicago | Unavailable | $909.07 |
How the 26517 rate is calculated
Each of 26517’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 · 26517
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.85Practice expense 14.58Malpractice 1.88
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26517
26517 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26517
Knuckle fusion
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| 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 · 26517
Knuckle fusion
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 50 · payment effect
With and without the modifier
26517 without 50 · national facility
$845.38
Knuckle fusion
26517-50 · Bilateral: 150%
$1,268.07
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
26517 compared with similar codes
Compare codes
26517 vs 26516 vs 26518 vs 26520 vs 26530: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26516Knuckle fusion
- Both are in the MCP fusion group. Use the full billing code descriptor and operative details to distinguish the code-level service; the CMS short label alone does not supply that distinction.
- 26518Knuckle fusion
- This is another code in the MCP fusion group. Confirm the full descriptor against the documented procedure rather than choosing between the codes from the abbreviated CMS labels.
- 26520Knuckle release
- 26520 is for release of an MCP contracture. Choose the fusion code when the surgeon fuses the knuckle joint, not when the documented service is contracture release.
- 26530Knuckle arthroplasty
- 26530 describes MCP joint revision, while this code represents fusion. The operative procedure determines which service was performed.
26517 billing questions
How is this code distinguished from a finger-joint fusion?
This code is for fusion at the MCP knuckle, where the finger meets the hand. A fusion at a finger interphalangeal joint is a different anatomic service.
What documentation supports reporting the code?
The operative report should identify the MCP joint and finger treated and describe the fusion performed. Include the indication and laterality when documented.
How is bilateral MCP fusion paid?
CMS lists bilateral reporting with modifier 50 at 150%. The operative documentation should establish that the procedure was performed on both sides.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
Can an assistant surgeon be paid for this procedure?
CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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