Billing code 26545: Finger joint reconstructionMedicare rate & RVUs in Ohio

Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability.

CMS RVU26DEffective Oct 1, 20261 payment locality118 Medicare services in 2024

CMS doesn’t publish an office rate for 26545 in Ohio.

—Office (non-facility)
$670.18Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 26545 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 26545 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 26545 covers

The surgeon reconstructs a stabilizing ligament at a finger joint using graft tissue when the existing ligament is deficient or unsuitable for a straightforward repair. This may be considered for persistent instability after an injury, including cases in which damaged ligament tissue cannot hold a direct repair. A hand or orthopedic surgeon typically performs the procedure in an operating room, with the operative report identifying the joint, the ligament addressed, and the graft used or obtained.

Report this service when the operative work supports ligament reconstruction with graft, rather than direct ligament repair or a joint replacement or fusion. Documentation should describe the instability or ligament deficiency, the reconstruction performed, and the graft. CMS classifies the procedure as major surgery with 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 others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

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.

26545 in Ohio

26545 office and facility rates by payment locality
Payment localityOfficeFacility
OhioUnavailable$670.18

How the 26545 rate is calculated

Each of 26545’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 26545

RVUs × geographic indexes × conversion factor

Work6.93

6.93 RVUs× 1.000 GPCI

Practice expense12.94

12.94 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

21.1800

Conversion factor

$33.4009

Medicare rate

$707.43

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26545

26545 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26545

Finger joint reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26545

Finger joint reconstruction

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26545 without 51 · national facility

$707.43

Finger joint reconstruction

26545-51 · Second procedure: 50%

$353.72

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

26545 compared with similar codes

Compare codes · National

4 codes, side by side

  • 26545

    Finger joint reconstruction6.93 wRVU

    Not priced

  • 26540

    Ligament repair6.44 wRVU

    Not priced

  • 26541

    Ligament repair8.59 wRVU

    Not priced

  • 26530

    Knuckle arthroplasty6.71 wRVU

    Not priced

How to choose

26540Ligament repair
26540 describes direct collateral ligament repair. Report 26545 when the surgeon reconstructs the ligament using graft tissue.
26541Ligament repair
26541 is a ligament repair involving a tendon graft; distinguish it from the reconstruction performed for this code by the operative technique documented.
26530Knuckle arthroplasty
26530 is arthroplasty of a metacarpophalangeal joint. It addresses the joint with an arthroplasty procedure, not ligament reconstruction.

26545 billing questions

How is this different from a direct ligament repair?

Use this code when the surgeon reconstructs the ligament with graft tissue. A direct repair of the existing ligament is a different service.

Does the code include obtaining the graft?

The operative documentation should identify the graft and the reconstruction performed. Check the applicable billing code descriptor and coding guidance before separately reporting graft procurement.

Can modifier 50 be used for both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not apply.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

When may an assistant-at-surgery be paid?

CMS payment for an assistant at surgery requires documentation of medical necessity. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 26545PPRRVU2026_Oct_nonQPP.csv, line 2,637 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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