No office rate
26540 describes direct collateral ligament repair. Report 26545 when the surgeon reconstructs the ligament using graft tissue.
On this page
CMS RVU26D · Effective 2026-10-01
26545 Finger joint reconstruction Medicare reimbursement rates in Kentucky
Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability. Compare 26545 office and facility rates across CMS payment localities in Kentucky.
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 26545 in Kentucky?
Kentucky 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
$655.74
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 26545: Finger joint ligament reconstruction with graft
Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability.
The surgeon reconstructs a stabilizing ligament at a finger joint using graft tissue when the existing ligament is deficient or unsuitable for a straightforward repair. This may be considered for persistent instability after an injury, including cases in which damaged ligament tissue cannot hold a direct repair. A hand or orthopedic surgeon typically performs the procedure in an operating room, with the operative report identifying the joint, the ligament addressed, and the graft used or obtained.
Report this service when the operative work supports ligament reconstruction with graft, rather than direct ligament repair or a joint replacement or fusion. Documentation should describe the instability or ligament deficiency, the reconstruction performed, and the graft. CMS classifies the procedure as major surgery with 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%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26545
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.93 · 33%
- Practice expense (office) RVU12.94 · 61%
- Malpractice RVU1.31 · 6%
118
Medicare services in 2024 · #4751 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.
26545 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
26541 is a ligament repair involving a tendon graft; distinguish it from the reconstruction performed for this code by the operative technique documented.
No office rate
26530 is arthroplasty of a metacarpophalangeal joint. It addresses the joint with an arthroplasty procedure, not ligament reconstruction.
Compare 26545 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$655.74
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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 26545 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,637
- Code
- 26545
- Physician work
- 6.93
- Practice expense
- 12.94
- Malpractice
- 1.31
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.93 | × 1.000 | 6.9300 |
| Practice expense | 12.94 | × 0.889 | 11.5037 |
| Malpractice | 1.31 | × 0.915 | 1.1986 |
| Total RVUs | 19.6323 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$655.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.93 | 1 |
| Practice expense | 12.94 | 0.889 |
| Malpractice | 1.31 | 0.915 |
(6.93 × 1 + 12.94 × 0.889 + 1.31 × 0.915) × $33.4009 = $655.74
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.
26545 billing questions
How is this different from a direct ligament repair?
Use this code when the surgeon reconstructs the ligament with graft tissue. A direct repair of the existing ligament is a different service.
Does the code include obtaining the graft?
The operative documentation should identify the graft and the reconstruction performed. Check the applicable CPT descriptor and coding guidance before separately reporting graft procurement.
Can modifier 50 be used for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not apply.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant-at-surgery be paid?
CMS payment for an assistant at surgery requires documentation of medical necessity. 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.
2,63426540,,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
2,63526541,,Repair hand joint with graft,A,,8.59,13.70,NA,13.70,,1.65,23.94,23.94,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63626542,,Repair hand joint with graft,A,,6.78,12.78,NA,12.78,,1.30,20.86,20.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63726545,,Reconstruct finger joint,A,,6.93,12.94,NA,12.94,,1.31,21.18,21.18,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63826546,,Repair nonunion hand,A,,10.56,17.16,NA,17.16,,2.02,29.74,29.74,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63926548,,Reconstruct finger joint,A,,8.01,13.39,NA,13.39,,1.53,22.93,22.93,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64026550,,Pollicization digit,A,,21.14,20.42,NA,20.42,,4.50,46.06,46.06,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631