No office rate
Use 26580 for reconstruction of a congenital central hand cleft. Code 26560 is for syndactyly repair, not central-deficiency reconstruction.
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CMS RVU26D · Effective 2026-10-01
26580 Cleft hand repair Medicare reimbursement rates in Ohio
Reconstructs a congenital central hand cleft, typically to improve hand structure and function when the metacarpal or digit pattern is deficient. Compare 26580 office and facility rates across CMS payment localities in Ohio.
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 26580 in Ohio?
Ohio 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
$1390.94
1 of 1 localities have a supported rate.
Payment area: Ohio
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 26580: Congenital cleft hand reconstruction
Reconstructs a congenital central hand cleft, typically to improve hand structure and function when the metacarpal or digit pattern is deficient.
This code represents operative reconstruction of a congenital cleft hand, a central deficiency that can leave a gap or abnormal separation in the hand’s skeletal and soft-tissue structure. A hand surgeon, commonly an orthopedic or plastic surgeon with hand expertise, performs the repair in an operating-room setting. The operative plan depends on the individual anatomy and may address the central cleft and associated deformity as part of the reconstruction.
Report the code when the operative diagnosis and procedure document repair of the cleft-hand deformity, rather than an isolated webbed-finger, extra-digit, or thumb-reconstruction procedure. The record should describe the affected hand, the congenital structural deficiency, and the reconstructive work performed. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 26580
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.26 · 44%
- Practice expense (office) RVU19.99 · 46%
- Malpractice RVU4.10 · 9%
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.
26580 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Code 26550 describes pollicization, a procedure that repositions a digit to create a thumb. It does not describe repair of a cleft hand.
No office rate
Code 26587 is for reconstruction of an extra digit. Code 26580 addresses the congenital central cleft rather than polydactyly.
Compare 26580 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1390.94
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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 26580 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,652
- Code
- 26580
- Physician work
- 19.26
- Practice expense
- 19.99
- Malpractice
- 4.10
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.26 | × 1.000 | 19.2600 |
| Practice expense | 19.99 | × 0.913 | 18.2509 |
| Malpractice | 4.10 | × 1.008 | 4.1328 |
| Total RVUs | 41.6437 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1390.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.26 | 1 |
| Practice expense | 19.99 | 0.913 |
| Malpractice | 4.1 | 1.008 |
(19.26 × 1 + 19.99 × 0.913 + 4.1 × 1.008) × $33.4009 = $1390.94
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.
26580 billing questions
How is cleft hand repair distinguished from syndactyly repair?
Cleft hand repair addresses a congenital central hand deficiency. Codes 26560–26562 are for repair of webbed fingers; select based on the operative condition and work documented.
Is this code used for reconstruction of an extra digit?
No. Code 26580 describes cleft-hand reconstruction; code 26587 is for reconstruction of an extra digit. The operative target should support the code reported.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral cleft hand repair reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,64926565,,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
2,65126568,,Lengthen metacarpal/finger,A,,9.04,16.32,NA,16.32,,1.92,27.28,27.28,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65226580,,Repair cleft hand,A,,19.26,19.99,NA,19.99,,4.10,43.35,43.35,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65326587,,Reconstruct extra finger,A,,14.14,11.93,NA,11.93,,3.01,29.08,29.08,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65426590,,Repair finger deformity,A,,18.20,18.03,NA,18.03,,3.88,40.11,40.11,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65526591,,Repair muscles of hand,A,,3.30,10.82,NA,10.82,,0.62,14.74,14.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703