No office rate
Both describe thumb carpometacarpal fusion; choose 26842 when autogenous bone graft is used and 26841 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
26842 Thumb fusion Medicare reimbursement rates in Nebraska
Reports fusion of the thumb’s carpometacarpal joint using autogenous bone graft, commonly for painful arthritis, instability, or post-traumatic joint damage. Compare 26842 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 26842 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
$742.41
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 26842: Thumb carpometacarpal fusion with autograft
Reports fusion of the thumb’s carpometacarpal joint using autogenous bone graft, commonly for painful arthritis, instability, or post-traumatic joint damage.
This operation fuses the carpometacarpal joint at the base of the thumb using the patient’s own bone graft. The surgeon prepares the joint surfaces, places graft to support fusion, and may use internal fixation to hold the bones in position. Hand or orthopedic surgeons commonly perform it in an operating room for symptomatic basal-joint arthritis, instability, or damage after trauma when fusion is selected. The graft-harvesting work is included in the service; document its source and use as part of the operative record.
Report this code when the operative documentation supports fusion of the thumb carpometacarpal joint with autogenous graft, rather than fusion of another thumb or hand joint or fusion without graft. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 26842
- 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
- 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 RVU8.28 · 34%
- Practice expense (office) RVU14.39 · 59%
- Malpractice RVU1.76 · 7%
95
Medicare services in 2024 · #4920 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.
26842 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
This code is for a grafted carpometacarpal fusion of a hand joint other than the thumb. Use 26842 when the fused joint is the thumb carpometacarpal joint.
No office rate
This code is for grafted metacarpophalangeal joint fusion. Code 26842 is for the thumb carpometacarpal joint.
Compare 26842 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
$742.41
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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 26842 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,693
- Code
- 26842
- Physician work
- 8.28
- Practice expense
- 14.39
- Malpractice
- 1.76
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.28 | × 1.000 | 8.2800 |
| Practice expense | 14.39 | × 0.923 | 13.2820 |
| Malpractice | 1.76 | × 0.378 | 0.6653 |
| Total RVUs | 22.2273 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$742.41
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.28 | 1 |
| Practice expense | 14.39 | 0.923 |
| Malpractice | 1.76 | 0.378 |
(8.28 × 1 + 14.39 × 0.923 + 1.76 × 0.378) × $33.4009 = $742.41
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.
26842 billing questions
How does this differ from 26841?
Use 26842 when the thumb carpometacarpal fusion includes autogenous bone graft. Code 26841 describes the corresponding fusion without graft.
Can the bone-graft harvest be billed separately?
The graft-obtaining work is included in this service. Document the graft source and its use in the fusion.
Which joint must be fused for this code?
The procedure must fuse the carpometacarpal joint at the base of the thumb. A fusion of a finger joint or another hand joint is not this service.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays this code at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be paid?
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.
2,69026785,,Treat finger dislocation,A,,6.44,8.01,NA,8.01,,1.25,15.70,15.70,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69126820,,Thumb fusion with graft,A,,8.24,14.38,NA,14.38,,1.75,24.37,24.37,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69226841,,Fusion of thumb,A,,7.17,13.91,NA,13.91,,1.41,22.49,22.49,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69326842,,Thumb fusion with graft,A,,8.28,14.39,NA,14.39,,1.76,24.43,24.43,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69426843,,Fusion of hand joint,A,,7.59,13.83,NA,13.83,,1.62,23.04,23.04,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69526844,,Fusion/graft of hand joint,A,,8.76,14.55,NA,14.55,,1.86,25.17,25.17,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69626850,,Fusion of knuckle,A,,6.96,12.87,NA,12.87,,1.32,21.15,21.15,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,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