No office rate
Both describe open treatment of CMC dislocations. Choose 26685 for a single dislocation and this code for multiple dislocations.
On this page
CMS RVU26D · Effective 2026-10-01
26686 Hand dislocation Medicare reimbursement rates in Kansas
Report open operative treatment of multiple carpometacarpal dislocations when the surgeon exposes and reduces the affected hand joints, with fixation when performed. Compare 26686 office and facility rates across CMS payment localities in Kansas.
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 26686 in Kansas?
Kansas 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
$538.63
1 of 1 localities have a supported rate.
Payment area: Kansas
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 26686: Open treatment of multiple hand joint dislocations
Report open operative treatment of multiple carpometacarpal dislocations when the surgeon exposes and reduces the affected hand joints, with fixation when performed.
This service covers open treatment of multiple carpometacarpal (CMC) joint dislocations in the hand. An orthopedic or hand surgeon exposes the involved joints, restores alignment, and may stabilize them with internal fixation. It is generally performed in a facility operating room for injuries requiring open reduction, such as multiple unstable CMC dislocations. The code distinguishes treatment of multiple joints from open treatment of a single CMC dislocation and from closed or percutaneous approaches.
Report the code when the operative record supports open treatment of multiple CMC dislocations; document the affected joints, approach, reduction, and any fixation. 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 multiple procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 26686
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.97 · 45%
- Practice expense (office) RVU8.08 · 46%
- Malpractice RVU1.69 · 10%
67
Medicare services in 2024 · #5170 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.
26686 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
26676 describes percutaneous skeletal fixation of a single CMC dislocation. This code is for open treatment of multiple dislocations.
$467.37
26675 is closed treatment with manipulation. This code is for open treatment of multiple CMC dislocations.
$425.66
26641 addresses a thumb CMC dislocation. This code covers open treatment of multiple CMC dislocations elsewhere in the hand.
Compare 26686 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
Kansas →
Office / nonfacility
Unavailable
Facility
$538.63
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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 26686 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,671
- Code
- 26686
- Physician work
- 7.97
- Practice expense
- 8.08
- Malpractice
- 1.69
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.97 | × 1.000 | 7.9700 |
| Practice expense | 8.08 | × 0.904 | 7.3043 |
| Malpractice | 1.69 | × 0.504 | 0.8518 |
| Total RVUs | 16.1261 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$538.63
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.97 | 1 |
| Practice expense | 8.08 | 0.904 |
| Malpractice | 1.69 | 0.504 |
(7.97 × 1 + 8.08 × 0.904 + 1.69 × 0.504) × $33.4009 = $538.63
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.
26686 billing questions
When should this code be chosen instead of 26685?
Use this code for open treatment of multiple CMC dislocations. Code 26685 is for open treatment of a single CMC dislocation.
How does this differ from closed treatment codes?
This code describes open operative treatment. Codes 26670 and 26675 describe closed treatment, without and with manipulation, respectively.
Does internal fixation have to be performed?
No. Fixation may be used, but the code covers open treatment whether or not internal fixation is performed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services 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 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.
2,66826675,,Treat hand dislocation,A,,4.71,9.70,,6.82,,1.02,15.43,12.55,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66926676,,Pin hand dislocation,A,,5.60,7.97,NA,7.97,,1.07,14.64,14.64,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67026685,,Treat hand dislocation,A,,6.89,7.95,NA,7.95,,1.19,16.03,16.03,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67126686,,Treat hand dislocation,A,,7.97,8.08,NA,8.08,,1.69,17.74,17.74,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67226700,,Treat knuckle dislocation,A,,3.73,7.62,,5.87,,0.83,12.18,10.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67326705,,Treat knuckle dislocation,A,,4.27,9.45,,6.69,,0.91,14.63,11.87,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67426706,,Pin knuckle dislocation,A,,5.18,6.45,NA,6.45,,0.89,12.52,12.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958