CPT code 26516: Knuckle fusion2026 Medicare rate & RVUs in Oregon
Reports surgical fusion of a metacarpophalangeal joint when the surgeon permanently stabilizes a finger or thumb knuckle.
CMS doesn’t publish an office rate for 26516 in Oregon.
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 26516 covers
The surgeon removes or prepares the opposing joint surfaces and positions the bones for permanent fusion, using fixation when needed. This operation may be performed by a hand or orthopedic surgeon for a painful, unstable, or severely damaged metacarpophalangeal (MCP) joint. The MCP joint is where a finger or thumb meets the hand; the operative report should identify the joint and document the reason for fusion and work performed.
Report 26516 for the MCP fusion itself, whether or not internal fixation is used. The 90-day global period includes 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 is paid only when medical necessity is documented; 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.
Where 26516 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $757.64 |
| Rest Of Oregon | Unavailable | $702.13 |
How the 26516 rate is calculated
Each of 26516’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 · 26516
RVUs × geographic indexes × conversion factor
Work7.14
7.14 RVUs× 1.000 GPCI
Practice expense12.97
12.97 RVUs× 1.000 GPCI
Malpractice1.37
1.37 RVUs× 1.000 GPCI
Adjusted RVUs
21.4800
Conversion factor
$33.4009
Medicare rate
$717.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26516
26516 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26516
Knuckle fusion
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 · 26516
Knuckle fusion
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 50 · payment effect
With and without the modifier
26516 without 50 · national facility
$717.45
Knuckle fusion
26516-50 · Bilateral: 150%
$1,076.18
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
26516 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26530Knuckle arthroplasty
- Use 26516 when the MCP joint is fused. Code 26530 describes MCP arthroplasty rather than fusion.
- 26531Knuckle arthroplasty
- Code 26531 describes MCP arthroplasty with an implant; 26516 is for MCP fusion, with or without fixation.
- 26520Knuckle release
- Code 26520 releases an MCP contracture. It does not describe permanently fusing the joint.
- 26517Knuckle fusion
- Both are nearby MCP fusion codes. Use the complete code descriptors and operative documentation to distinguish the specific service reported.
26516 billing questions
Does internal fixation change the code?
No. Code 26516 covers MCP fusion with or without internal fixation. The operative report should still describe the joint and fusion performed.
How is this different from MCP arthroplasty?
Fusion permanently stabilizes the MCP joint. Codes 26530 and 26531 describe MCP arthroplasty, which is a different procedure involving joint reconstruction, with 26531 specifying an implant.
Can 26516 be reported for more than one fused joint?
Document each joint fused and verify the applicable code descriptor and reporting instructions for the complete operative work. Do not infer the unit count from the diagnosis alone.
When is modifier 50 used?
For bilateral performance, CMS pays code 26516 with modifier 50 at 150%. The documentation should support fusion on both sides.
Is postoperative care separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
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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