No office rate
Both address MCP joint arthroplasty, but 26531 is for prosthetic replacement. Use 26530 when the procedure does not include a prosthetic replacement.
On this page
CMS RVU26D · Effective 2026-10-01
26530 Knuckle arthroplasty Medicare reimbursement rates in Maine
Report this procedure for arthroplasty of a metacarpophalangeal joint when the surgeon reshapes or removes damaged joint surfaces without prosthetic replacement. Compare 26530 office and facility rates across CMS payment localities in Maine.
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 26530 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$474.11–$491.74
2 of 2 localities have a supported rate.
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 26530: Metacarpophalangeal joint arthroplasty
Report this procedure for arthroplasty of a metacarpophalangeal joint when the surgeon reshapes or removes damaged joint surfaces without prosthetic replacement.
This code covers arthroplasty of a metacarpophalangeal (MCP) joint, the knuckle connecting a finger or thumb to the hand. A hand surgeon may reshape or remove damaged joint surfaces and address the joint’s alignment or motion. Typical clinical situations include painful arthritis or joint deformity affecting MCP function. The prosthetic-replacement version is a separate code, so the operative report should make clear whether an implant was used.
Report the service for each MCP joint treated, supported by documentation of the specific joint, the indication, and the work performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare may pay for an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 26530
- 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 RVU6.71 · 44%
- Practice expense (office) RVU7.27 · 48%
- Malpractice RVU1.28 · 8%
428
Medicare services in 2024 · #3674 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.
26530 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
This code is for arthroplasty of an interphalangeal joint, between finger bones. Code 26530 is for the MCP knuckle joint.
No office rate
This code describes release of an MCP contracture. It is not a substitute for arthroplasty when the surgeon operates on the joint surfaces.
Compare 26530 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$474.11
Southern Maine →
Office / nonfacility
Unavailable
Facility
$491.74
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26530 billing questions
When should 26530 be reported instead of 26531?
Use 26530 for MCP joint arthroplasty without prosthetic replacement. When the surgeon uses a prosthetic replacement, the related code is 26531.
How is the number of services determined?
The code is reported for each MCP joint treated. The operative report should identify the specific joint or joints and the procedure performed.
Can modifier 50 be used when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Document the joints treated and follow applicable claim reporting instructions for the number of services.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant surgeon be paid for this procedure?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
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.
2,62726518,,Fusion of knuckle joints,A,,9.04,14.64,NA,14.64,,1.92,25.60,25.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62826520,,Release knuckle contracture,A,,5.33,13.73,NA,13.73,,1.02,20.08,20.08,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62926525,,Release finger contracture,A,,5.36,13.87,NA,13.87,,1.04,20.27,20.27,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63026530,,Revise knuckle joint,A,,6.71,7.27,NA,7.27,,1.28,15.26,15.26,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63126531,,Revise knuckle with implant,A,,7.93,8.19,NA,8.19,,1.49,17.61,17.61,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63226535,,Revise finger joint,A,,5.27,6.30,NA,6.30,,1.00,12.57,12.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63326536,,Revise/implant finger joint,A,,6.40,14.27,NA,14.27,,1.22,21.89,21.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00