Billing code 26550: Thumb reconstructionMedicare rate & RVUs in Illinois
Reports surgery that repositions an existing finger, typically the index finger, into the thumb position to create a functional opposable thumb.
CMS doesn’t publish an office rate for 26550 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 26550 covers
A hand surgeon uses an existing finger, usually the index finger, to create a thumb when the thumb is absent or severely underdeveloped. The operation moves and reshapes the digit into the thumb position, with adjustments to its bones, tendons, nerves, blood supply, and surrounding skin to support opposition and grasp. It is performed in an operating room, commonly for congenital hand differences such as thumb hypoplasia or absence.
Report the code when the operative work is pollicization, rather than a toe-to-hand transfer or a less extensive change in finger position. The operative report should identify the digit moved, the recipient thumb position, laterality, and reconstructive work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 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 26550 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 | $1,741.44 |
| East St. Louis | Unavailable | $1,636.29 |
| Rest Of Illinois | Unavailable | $1,563.73 |
| Suburban Chicago | Unavailable | $1,677.84 |
How the 26550 rate is calculated
Each of 26550’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 · 26550
RVUs × geographic indexes × conversion factor
Work21.14
21.14 RVUs× 1.000 GPCI
Practice expense20.42
20.42 RVUs× 1.000 GPCI
Malpractice4.50
4.50 RVUs× 1.000 GPCI
Adjusted RVUs
46.0600
Conversion factor
$33.4009
Medicare rate
$1,538.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26550
26550 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26550
Thumb reconstruction
| 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 · 26550
Thumb reconstruction
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
26550 without 50 · national facility
$1,538.45
Thumb reconstruction
26550-50 · Bilateral: 150%
$2,307.68
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).
26550 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26551Toe-to-hand transfer
- Choose 26551 when the great toe is transferred to the hand. Code 26550 repositions an existing finger to form a thumb.
- 26553Toe-hand transfer
- 26553 describes a single toe transferred to the hand; 26550 uses a finger already on the hand to create the thumb.
- 26555Finger transfer
- 26555 covers repositioning a finger when the operation is not pollicization to create a thumb.
26550 billing questions
When should 26550 be chosen instead of a toe-to-hand transfer code?
Use 26550 when an existing finger is repositioned to create the thumb. A toe transferred from the foot to the hand is a different operation, represented by codes such as 26551 or 26553.
How does 26550 differ from 26555?
26550 describes converting a digit into a thumb at the thumb position. Consider 26555 when the operation changes a finger's position but does not perform pollicization.
What documentation supports reporting 26550?
Document the thumb deficiency or absence, the digit used, its new position, laterality, and the reconstructive steps performed to create thumb function.
How are bilateral procedures and other same-session procedures paid?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
What postoperative care is included, and may an assistant be paid?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid; 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
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