No office rate
Both codes concern interphalangeal joint arthroplasty. Choose 26536 when a prosthetic implant is placed; 26535 represents the nonimplant procedure.
On this page
CMS RVU26D · Effective 2026-10-01
26535 Finger joint surgery Medicare reimbursement rates in Pennsylvania
Reports arthroplasty of a finger interphalangeal joint without a prosthetic implant, commonly for painful joint damage or deformity. Compare 26535 office and facility rates across CMS payment localities in Pennsylvania.
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 26535 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$400.76–$438.09
2 of 2 localities have a supported rate.
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 26535: Finger interphalangeal joint arthroplasty
Reports arthroplasty of a finger interphalangeal joint without a prosthetic implant, commonly for painful joint damage or deformity.
This operation reshapes or removes damaged surfaces at a finger interphalangeal joint to improve pain and function without placing a prosthetic implant. Hand surgeons typically perform it for a painful, stiff or deformed joint affected by arthritis or prior injury. The operative report should identify the specific finger joint and describe the joint work performed; this code is distinct from arthroplasty of a knuckle joint at the metacarpophalangeal level and from implant arthroplasty.
Report the service for each treated interphalangeal joint, supported by documentation of the joint and the nonimplant procedure. CMS assigns 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 26535
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.27 · 42%
- Practice expense (office) RVU6.30 · 50%
- Malpractice RVU1.00 · 8%
532
Medicare services in 2024 · #3499 by national volume
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.
26535 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
This code is for arthroplasty at a metacarpophalangeal joint, the knuckle. Code 26535 concerns an interphalangeal joint.
No office rate
Code 26531 describes metacarpophalangeal arthroplasty with an implant. Code 26535 is for an interphalangeal joint without a prosthetic implant.
No office rate
Use 26525 for release of a finger contracture when the documented work is contracture release. Code 26535 describes arthroplasty of the interphalangeal joint.
Compare 26535 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$438.09
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$400.76
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26535 billing questions
How is this different from 26536?
26535 describes interphalangeal joint arthroplasty without a prosthetic implant. Use 26536 when the operative service includes a prosthetic implant.
How does this differ from 26530 or 26531?
Those codes describe arthroplasty at a metacarpophalangeal, or knuckle, joint. Code 26535 is for an interphalangeal joint farther along the finger.
How many units should be reported?
The code is reported for each treated interphalangeal joint. The operative note should identify each joint and the procedure performed there.
Can modifier 50 be used when both hands are treated?
CMS identifies modifier 50 as inappropriate for this code’s descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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 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.
2,62926525,,Release finger contracture,A,,5.36,13.87,NA,13.87,,1.04,20.27,20.27,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63026530,,Revise knuckle joint,A,,6.71,7.27,NA,7.27,,1.28,15.26,15.26,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63126531,,Revise knuckle with implant,A,,7.93,8.19,NA,8.19,,1.49,17.61,17.61,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63226535,,Revise finger joint,A,,5.27,6.30,NA,6.30,,1.00,12.57,12.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63326536,,Revise/implant finger joint,A,,6.40,14.27,NA,14.27,,1.22,21.89,21.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63426540,,Repair hand joint,A,,6.44,12.66,NA,12.66,,1.24,20.34,20.34,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63526541,,Repair hand joint with graft,A,,8.59,13.70,NA,13.70,,1.65,23.94,23.94,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00