$373.28–$413.08
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.
On this page
CMS RVU26D · Effective 2026-10-01
26720 Finger fracture care Medicare reimbursement rates in Pennsylvania
Closed, nonmanipulative care for a proximal or middle phalanx shaft fracture of a finger or thumb, reported separately for each treated fracture. Compare 26720 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 26720 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
$221.20–$245.64
2 of 2 localities have a supported rate.
Facility setting
$193.30–$214.00
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.
Fracture care
About 26720: Closed treatment of phalangeal shaft fracture
Closed, nonmanipulative care for a proximal or middle phalanx shaft fracture of a finger or thumb, reported separately for each treated fracture.
CPT 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.
CMS billing rules for 26720
- 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 RVU1.72 · 24%
- Practice expense (office) RVU4.97 · 70%
- Malpractice RVU0.36 · 5%
7.4K
Medicare services in 2024 · #1631 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.
26720 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
26720 describes closed treatment without manipulation. Use 26727 when the shaft fracture is treated with percutaneous skeletal fixation.
No office rate
26720 is closed treatment without manipulation; 26735 is for open treatment of a proximal or middle phalanx shaft fracture.
$246.58–$273.38
26740 applies to an articular fracture involving a finger joint, rather than a shaft fracture of the proximal or middle phalanx.
Compare 26720 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
$245.64
Facility
$214.00
Rest Of Pennsylvania →
Office / nonfacility
$221.20
Facility
$193.30
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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 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.
2,67326705,,Treat knuckle dislocation,A,,4.27,9.45,,6.69,,0.91,14.63,11.87,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67426706,,Pin knuckle dislocation,A,,5.18,6.45,NA,6.45,,0.89,12.52,12.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67526715,,Treat knuckle dislocation,A,,6.85,8.15,NA,8.15,,1.32,16.32,16.32,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67626720,,Treat finger fracture each,A,,1.72,4.97,,4.06,,0.36,7.05,6.14,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67726725,,Treat finger fracture each,A,,3.39,7.74,,5.53,,0.72,11.85,9.64,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67826727,,Treat finger fracture each,A,,5.28,7.36,NA,7.36,,1.04,13.68,13.68,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,67926735,,Treat finger fracture each,A,,7.23,8.27,NA,8.27,,1.40,16.90,16.90,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00