No office rate
Choose 26540 for collateral ligament repair without a tendon graft; 26542 captures repair using a tendon graft.
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CMS RVU26D · Effective 2026-10-01
26542 Joint ligament repair Medicare reimbursement rates in Rhode Island
Reports repair of a hand joint collateral ligament using a tendon graft when the surgeon restores stability at a metacarpophalangeal or interphalangeal joint. Compare 26542 office and facility rates across CMS payment localities in Rhode Island.
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 26542 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$710.44
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 26542: Hand joint ligament repair with tendon graft
Reports repair of a hand joint collateral ligament using a tendon graft when the surgeon restores stability at a metacarpophalangeal or interphalangeal joint.
The surgeon repairs a deficient collateral ligament at a metacarpophalangeal or interphalangeal joint using a tendon graft. This may be needed for chronic instability or a ligament injury that cannot be adequately repaired with the patient’s existing tissue. Hand surgeons typically perform the operation in a hospital outpatient department or ambulatory surgery center; a tendon graft may be harvested as part of the procedure.
Report the code when the operative work includes ligament repair with a tendon graft, rather than direct repair or augmentation using local tissue. The operative report should identify the joint, ligament, instability or injury, graft, and repair technique. 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% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26542
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.78 · 33%
- Practice expense (office) RVU12.78 · 61%
- Malpractice RVU1.30 · 6%
248
Medicare services in 2024 · #4143 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.
26542 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Choose 26541 when local tissue is used for the ligament repair. A tendon graft points to 26542.
No office rate
26545 describes collateral ligament reconstruction at the metacarpophalangeal joint with a tendon graft. Distinguish it from 26542 by the procedure performed and the joint involved.
Compare 26542 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$710.44
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 26542 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,636
- Code
- 26542
- Physician work
- 6.78
- Practice expense
- 12.78
- Malpractice
- 1.30
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.78 | × 1.019 | 6.9088 |
| Practice expense | 12.78 | × 1.033 | 13.2017 |
| Malpractice | 1.30 | × 0.892 | 1.1596 |
| Total RVUs | 21.2702 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$710.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.78 | 1.019 |
| Practice expense | 12.78 | 1.033 |
| Malpractice | 1.3 | 0.892 |
(6.78 × 1.019 + 12.78 × 1.033 + 1.3 × 0.892) × $33.4009 = $710.44
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
26542 billing questions
How does this differ from 26540?
Use 26542 when the collateral ligament repair uses a tendon graft. Code 26540 describes collateral ligament repair without that graft technique.
How does this differ from 26541?
Code 26541 is for collateral ligament repair using local tissue. Code 26542 identifies repair with a tendon graft.
What should the operative note document?
Document the affected metacarpophalangeal or interphalangeal joint, the collateral ligament and its deficiency, and the tendon graft repair performed.
Can modifier 50 be used for both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy makes modifier 50 unsuitable.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%. Assistant-at-surgery payment requires documented medical necessity.
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.
2,63326536,,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
2,63626542,,Repair hand joint with graft,A,,6.78,12.78,NA,12.78,,1.30,20.86,20.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63726545,,Reconstruct finger joint,A,,6.93,12.94,NA,12.94,,1.31,21.18,21.18,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63826546,,Repair nonunion hand,A,,10.56,17.16,NA,17.16,,2.02,29.74,29.74,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63926548,,Reconstruct finger joint,A,,8.01,13.39,NA,13.39,,1.53,22.93,22.93,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537