Billing code 26720: Finger fracture careMedicare rate & RVUs in Ohio
Closed, nonmanipulative care for a proximal or middle phalanx shaft fracture of a finger or thumb, reported separately for each treated fracture.
Medicare pays $221.13 for 26720 in the office in Ohio (Ohio). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 26720 covers
billing code 26720 covers closed management of a shaft fracture in the proximal or middle phalanx of a finger or thumb when the fracture is treated without manipulation. A typical case is a stable proximal phalanx shaft fracture managed with immobilization rather than reduction. Orthopedic and hand surgeons commonly provide this care; it may be initiated in an office or facility setting.
Report the code for each treated fracture. Documentation should identify the digit, phalanx and shaft location, closed treatment approach, and the plan showing that manipulation was not performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, and 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.
26720 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $221.13 | $193.38 |
How the 26720 rate is calculated
Each of 26720’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 · 26720
RVUs × geographic indexes × conversion factor
Work1.72
1.72 RVUs× 1.000 GPCI
Practice expense4.97
4.97 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
7.0500
Conversion factor
$33.4009
Medicare rate
$235.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26720
26720 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26720
Finger fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26720
Finger fracture care
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26720 without 51 · national office
$235.48
Finger fracture care
26720-51 · Second procedure: 50%
$117.74
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%).
26720 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26725Finger fracture treatment
- Both codes address closed treatment of a proximal or middle phalanx shaft fracture. Choose 26720 when treatment does not involve manipulation; choose 26725 when manipulation is performed.
- 26727Finger fracture care
- 26720 describes closed treatment without manipulation. Use 26727 when the shaft fracture is treated with percutaneous skeletal fixation.
- 26735Finger fracture repair
- 26720 is closed treatment without manipulation; 26735 is for open treatment of a proximal or middle phalanx shaft fracture.
- 26740Finger fracture
- 26740 applies to an articular fracture involving a finger joint, rather than a shaft fracture of the proximal or middle phalanx.
26720 billing questions
When should 26720 be chosen over 26725?
Use 26720 for closed treatment of a proximal or middle phalanx shaft fracture without manipulation. Code 26725 describes the corresponding treatment when manipulation is performed.
Can 26720 be used for a distal phalanx fracture?
No. This code is for shaft fractures of the proximal or middle phalanx; 26750 is the closed-treatment code for a distal phalanx fracture without manipulation.
Should modifier 50 be appended for fractures on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the treated fractures individually rather than using modifier 50.
Are routine fracture follow-up visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle multiple procedures in the same session?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported for 26720?
Assistant-at-surgery services are not paid for this code. 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
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