No office rate
Choose 26560 for simple syndactyly reconstruction without a skin graft; 26561 represents the complex reconstruction level.
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CMS RVU26D · Effective 2026-10-01
26561 Web-space repair Medicare reimbursement rates in Nebraska
Reports complex reconstruction to separate fused fingers and form a web space, often requiring skin graft coverage, rather than a simple syndactyly repair. Compare 26561 office and facility rates across CMS payment localities in Nebraska.
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 26561 in Nebraska?
Nebraska 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
$859.16
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 26561: Complex syndactyly reconstruction with graft
Reports complex reconstruction to separate fused fingers and form a web space, often requiring skin graft coverage, rather than a simple syndactyly repair.
This operation separates fingers joined by congenital webbing and reconstructs the space between them. Complex cases may require skin graft coverage after the digits are released and the web space is shaped. Hand surgeons and plastic surgeons typically perform the reconstruction in an operating room, with the operative report describing the involved digits, web space, release, and coverage technique.
Select this code when the documented reconstruction is complex, rather than the simple repair represented by 26560 or the complicated reconstruction represented by 26562. The operative note should support the extent of the webbing and the reconstructive work, including graft use when performed. Medicare assigns 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 26561
- 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 RVU10.82 · 38%
- Practice expense (office) RVU15.20 · 54%
- Malpractice RVU2.31 · 8%
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.
26561 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Choose 26562 when the syndactyly is complicated, such as synpolydactyly, and requires multiple procedures; 26561 is the complex reconstruction level.
No office rate
26580 addresses reconstruction of a cleft hand. It is not the code for separating fingers joined by syndactyly.
Compare 26561 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$859.16
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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 26561 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,647
- Code
- 26561
- Physician work
- 10.82
- Practice expense
- 15.20
- Malpractice
- 2.31
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.82 | × 1.000 | 10.8200 |
| Practice expense | 15.20 | × 0.923 | 14.0296 |
| Malpractice | 2.31 | × 0.378 | 0.8732 |
| Total RVUs | 25.7228 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$859.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.82 | 1 |
| Practice expense | 15.2 | 0.923 |
| Malpractice | 2.31 | 0.378 |
(10.82 × 1 + 15.2 × 0.923 + 2.31 × 0.378) × $33.4009 = $859.16
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.
26561 billing questions
How does 26561 differ from 26560?
26561 represents complex syndactyly reconstruction, often involving skin graft coverage. 26560 is for a simple reconstruction without a skin graft.
When would 26562 be a better fit?
Use 26562 for a complicated reconstruction, such as synpolydactyly, that requires multiple procedures. The operative report should establish that greater complexity.
Can modifier 50 be used when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not append modifier 50.
What documentation supports 26561?
Document the fused digits and web space, the release and reconstruction performed, and graft work when applicable. The note should show why the repair is complex rather than simple or complicated.
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. The global period applies to care related to this reconstruction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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.
2,64426555,,Positional change of finger,A,,16.65,18.99,NA,18.99,,3.55,39.19,39.19,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64526556,,Toe joint transfer,A,,48.51,33.33,NA,33.33,,10.37,92.21,92.21,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64626560,,Repair of web finger,A,,5.38,12.57,NA,12.57,,1.15,19.10,19.10,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64726561,,Repair of web finger,A,,10.82,15.20,NA,15.20,,2.31,28.33,28.33,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64826562,,Repair of web finger,A,,16.26,19.49,NA,19.49,,3.46,39.21,39.21,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64926565,,Correct metacarpal flaw,A,,6.74,12.62,NA,12.62,,1.31,20.67,20.67,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65026567,,Correct finger deformity,A,,6.82,12.81,NA,12.81,,1.33,20.96,20.96,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068