$495.55–$544.88
Both address a thumb carpometacarpal fracture-dislocation by closed treatment. Choose 26650 when manipulation is performed; 26645 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
26650 Thumb fracture-dislocation Medicare reimbursement rates in Massachusetts
Reports closed reduction of a thumb carpometacarpal fracture-dislocation, such as a Bennett-type injury, when the physician manipulates the bones into alignment. Compare 26650 office and facility rates across CMS payment localities in Massachusetts.
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 26650 in Massachusetts?
Massachusetts 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
$480.22–$524.68
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 26650: Closed reduction of thumb base fracture-dislocation
Reports closed reduction of a thumb carpometacarpal fracture-dislocation, such as a Bennett-type injury, when the physician manipulates the bones into alignment.
This service treats a fracture-dislocation at the base of the thumb metacarpal where it meets the wrist-side carpal bone. A hand or orthopedic surgeon manipulates the injured bones back into alignment without surgically opening the joint; a Bennett-type injury is a typical example. Treatment is commonly performed in an operating room or other procedural setting, with imaging used to assess alignment as appropriate.
Report 26650 when the provider performs manipulation to reduce the thumb carpometacarpal fracture-dislocation. The record should identify the injury and document the reduction; a thumb metacarpal fracture elsewhere in the bone is not this joint injury. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26650
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.22 · 37%
- Practice expense (office) RVU7.83 · 56%
- Malpractice RVU1.04 · 7%
105
Medicare services in 2024 · #4842 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.
26650 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
26650 is closed reduction by manipulation. 26665 applies when the fracture-dislocation is treated through an open approach.
$481.82–$531.00
26641 is for a thumb carpometacarpal dislocation without a fracture. Use 26650 for a fracture-dislocation requiring closed manipulation.
$387.52–$428.19
26605 treats a metacarpal fracture with manipulation, rather than the thumb carpometacarpal fracture-dislocation addressed by 26650.
Compare 26650 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
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$524.68
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$480.22
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26650 billing questions
When should 26650 be chosen over 26645?
Use 26650 when the physician manipulates a thumb carpometacarpal fracture-dislocation to restore alignment. Code 26645 is the related closed-treatment option when manipulation is not performed.
How does 26650 differ from 26665?
26650 describes closed reduction by manipulation. Choose 26665 when the thumb carpometacarpal fracture-dislocation is treated through an open surgical approach.
Can a separate reduction or manipulation service be billed with 26650?
The manipulation is part of the closed fracture-dislocation treatment represented by 26650; do not separately report that same reduction as another service.
What documentation supports reporting 26650?
Document the thumb carpometacarpal fracture-dislocation and the physician's manipulation to reduce it. The record should distinguish this joint injury from a fracture elsewhere in the thumb metacarpal.
How are bilateral cases and other same-session procedures handled?
For bilateral treatment, modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Is an assistant or co-surgeon payable for 26650?
Assistant-at-surgery payment is subject to a statutory restriction for this code. 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.
2,66226615,,Treat metacarpal fracture,A,,6.89,8.18,NA,8.18,,1.33,16.40,16.40,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66326641,,Treat thumb dislocation,A,,4.03,9.16,,6.61,,0.86,14.05,11.50,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66426645,,Treat thumb fracture,A,,4.47,9.05,,6.30,,0.96,14.48,11.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66526650,,Treat thumb fracture,A,,5.22,7.83,NA,7.83,,1.04,14.09,14.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66626665,,Treat thumb fracture,A,,7.74,8.24,NA,8.24,,1.32,17.30,17.30,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66726670,,Treat hand dislocation,A,,3.73,8.28,,6.11,,0.86,12.87,10.70,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66826675,,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