No office rate
Both describe knuckle-joint fusion services. Use the code whose CPT descriptor matches the specific joints and extent documented in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
26518 Knuckle fusion Medicare reimbursement rates in New Jersey
Surgical fusion of multiple finger knuckle joints, reported when the operative plan permanently joins the joints rather than releasing or reconstructing them. Compare 26518 office and facility rates across CMS payment localities in New Jersey.
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 26518 in New Jersey?
New Jersey 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
$918.35–$956.68
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 26518: Multiple knuckle joint fusion
Surgical fusion of multiple finger knuckle joints, reported when the operative plan permanently joins the joints rather than releasing or reconstructing them.
A hand surgeon prepares the involved finger knuckle joints and holds the joint surfaces together so they can fuse in a planned position. The operation may address painful deformity, instability, or joint damage when preserving motion is not the goal. It is generally performed in an operating room, with the operative report identifying each joint treated and the fixation or other techniques used.
Report this code for the multiple-joint fusion service it represents, using the operative documentation to support the joints fused and the work performed. It has 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% reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 26518
- 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 RVU9.04 · 35%
- Practice expense (office) RVU14.64 · 57%
- Malpractice RVU1.92 · 8%
30
Medicare services in 2024 · #5664 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.
26518 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
This code addresses fusion; 26520 releases a knuckle-joint contracture without making fusion the operative goal.
No office rate
Fusion permanently joins the joint, while 26530 describes knuckle-joint revision intended to address the joint without the same fusion service.
Compare 26518 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$956.68
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$918.35
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26518 billing questions
How is this different from 26516?
Both codes concern fusion of knuckle joints, but the code choice depends on the specific service represented by the operative report. Confirm the joint sites and extent of fusion against the applicable CPT descriptor rather than choosing by the general term “knuckle.”
Is routine postoperative care separately reported?
The 90-day global period includes related postoperative care and the preoperative visit on the day before surgery. Separately report only services that are distinct from the included global care and meet applicable coding requirements.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction, with payment at 50%.
Can modifier 50 be used when both hands are treated?
CMS identifies this as a bilateral procedure. When performed bilaterally and reported with modifier 50, payment is at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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.
2,62426510,,Thumb tendon transfer,A,,5.46,12.28,NA,12.28,,1.05,18.79,18.79,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62526516,,Fusion of knuckle joint,A,,7.14,12.97,NA,12.97,,1.37,21.48,21.48,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62626517,,Fusion of knuckle joints,A,,8.85,14.58,NA,14.58,,1.88,25.31,25.31,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62726518,,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