No office rate
Use 26843 for a nonthumb carpometacarpal fusion without autogenous bone grafting; 26844 is the corresponding graft procedure.
On this page
CMS RVU26D · Effective 2026-10-01
26843 Hand joint fusion Medicare reimbursement rates in Iowa
Fusion of a carpometacarpal joint in the hand other than the thumb, reported when the surgeon permanently joins that joint. Compare 26843 office and facility rates across CMS payment localities in Iowa.
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 26843 in Iowa?
Iowa 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
$697.66
1 of 1 localities have a supported rate.
Payment area: Iowa
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 26843: Nonthumb carpometacarpal joint fusion
Fusion of a carpometacarpal joint in the hand other than the thumb, reported when the surgeon permanently joins that joint.
An orthopedic or hand surgeon uses this service to fuse a carpometacarpal joint other than the thumb’s. The surgeon prepares the joint surfaces and stabilizes them to promote bony union. Typical situations include a painful, arthritic or unstable joint at the base of a finger metacarpal. The procedure is generally performed in an operating room; fixation may be used. This code is for the fusion without autogenous bone grafting.
Select the code based on the joint fused: this code identifies a nonthumb carpometacarpal joint, while 26844 is the graft counterpart. Document the specific joint, the reason for fusion, and the operative work supporting arthrodesis. The 90-day global period includes 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 26843
- 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 RVU7.59 · 33%
- Practice expense (office) RVU13.83 · 60%
- Malpractice RVU1.62 · 7%
25
Medicare services in 2024 · #5779 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.
26843 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
26841 addresses carpometacarpal fusion of the thumb. This code is for a carpometacarpal joint other than the thumb’s.
No office rate
26850 is for fusion at a metacarpophalangeal joint, where a finger meets the hand; 26843 is for a carpometacarpal joint.
No office rate
26860 is for fusion at an interphalangeal joint within a finger. Use 26843 for a nonthumb carpometacarpal joint.
Compare 26843 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
Iowa →
Office / nonfacility
Unavailable
Facility
$697.66
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 26843 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,694
- Code
- 26843
- Physician work
- 7.59
- Practice expense
- 13.83
- Malpractice
- 1.62
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.59 | × 1.000 | 7.5900 |
| Practice expense | 13.83 | × 0.915 | 12.6545 |
| Malpractice | 1.62 | × 0.397 | 0.6431 |
| Total RVUs | 20.8876 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$697.66
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.59 | 1 |
| Practice expense | 13.83 | 0.915 |
| Malpractice | 1.62 | 0.397 |
(7.59 × 1 + 13.83 × 0.915 + 1.62 × 0.397) × $33.4009 = $697.66
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.
26843 billing questions
How is this different from the thumb fusion codes?
This code is for a carpometacarpal joint other than the thumb’s. Thumb carpometacarpal fusion is reported with 26841 or, when autogenous bone graft is used, 26842.
When is 26844 used instead?
Use 26844 for fusion of a nonthumb carpometacarpal joint when autogenous bone graft is used. Document the graft and the joint fused.
Can modifier 50 be appended for both hands?
No. CMS identifies the bilateral adjustment as inapplicable for this descriptor or anatomy, so modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction at 50%. An assistant at surgery may be paid.
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.
2,69126820,,Thumb fusion with graft,A,,8.24,14.38,NA,14.38,,1.75,24.37,24.37,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69226841,,Fusion of thumb,A,,7.17,13.91,NA,13.91,,1.41,22.49,22.49,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69326842,,Thumb fusion with graft,A,,8.28,14.39,NA,14.39,,1.76,24.43,24.43,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69426843,,Fusion of hand joint,A,,7.59,13.83,NA,13.83,,1.62,23.04,23.04,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69526844,,Fusion/graft of hand joint,A,,8.76,14.55,NA,14.55,,1.86,25.17,25.17,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69626850,,Fusion of knuckle,A,,6.96,12.87,NA,12.87,,1.32,21.15,21.15,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69726852,,Fusion of knuckle with graft,A,,8.49,13.71,NA,13.71,,1.61,23.81,23.81,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136