Billing code 26725: Finger fracture treatmentMedicare rate & RVUs in Oklahoma
Closed treatment of a proximal or middle phalanx shaft fracture with manipulation, reported for each finger or thumb fracture treated.
Medicare pays $362.78 for 26725 in the office in Oklahoma (Oklahoma). 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 26725 covers
This service is for a shaft fracture of the proximal or middle phalanx of a finger or thumb when the clinician manipulates the fracture to improve alignment without surgically exposing it. An orthopedic or hand surgeon commonly performs the reduction in an office, emergency department, or operating room, then immobilizes the digit with an appropriate splint or cast. The code is reported for each fracture treated.
Documentation should identify the digit and phalanx, establish that the fracture involves the shaft, and support the need for and performance of manipulation. This code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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.
26725 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $362.78 | $296.86 |
How the 26725 rate is calculated
Each of 26725’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 · 26725
RVUs × geographic indexes × conversion factor
Work3.39
3.39 RVUs× 1.000 GPCI
Practice expense7.74
7.74 RVUs× 1.000 GPCI
Malpractice0.72
0.72 RVUs× 1.000 GPCI
Adjusted RVUs
11.8500
Conversion factor
$33.4009
Medicare rate
$395.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26725
26725 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26725
Finger fracture treatment
| 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 · 26725
Finger fracture treatment
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
26725 without 51 · national office
$395.80
Finger fracture treatment
26725-51 · Second procedure: 50%
$197.90
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%).
26725 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26720Finger fracture care
- Use 26720 when a proximal or middle phalanx shaft fracture is treated without manipulation. This code requires manipulation.
- 26727Finger fracture care
- 26727 includes skeletal traction with manipulation for a proximal or middle phalanx shaft fracture; this code describes manipulation without that traction.
- 26735Finger fracture repair
- 26735 is for open treatment of a proximal or middle phalanx shaft fracture. This code is for closed treatment with manipulation.
- 26740Finger fracture
- 26740 concerns a fracture involving a metacarpophalangeal or interphalangeal joint. This code is for a proximal or middle phalanx shaft fracture.
26725 billing questions
How does this differ from 26720?
26725 is for a proximal or middle phalanx shaft fracture that is manipulated to improve alignment. Use 26720 when the fracture is treated without manipulation.
When would 26727 be more appropriate?
26727 describes treatment of this shaft-fracture type with manipulation and skeletal traction. This code covers manipulation without that traction method.
Can the reduction and splinting be billed as separate fracture services?
The manipulation and immediate immobilization are part of the closed fracture treatment. Do not report the same treatment as an open or percutaneous fixation procedure.
Should modifier 50 be used for fractures on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service for each fracture treated, following applicable claim-edit instructions.
What documentation supports reporting this code?
Document the affected digit and phalanx, the shaft-fracture location, the manipulation performed, and the resulting treatment plan or immobilization.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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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