No office rate
Use 26516 when the MCP joint is fused. Code 26530 describes MCP arthroplasty rather than fusion.
On this page
CMS RVU26D · Effective 2026-10-01
26516 Knuckle fusion Medicare reimbursement rates in Tennessee
Reports surgical fusion of a metacarpophalangeal joint when the surgeon permanently stabilizes a finger or thumb knuckle. Compare 26516 office and facility rates across CMS payment localities in Tennessee.
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 26516 in Tennessee?
Tennessee 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
$656.84
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 26516: Metacarpophalangeal joint fusion
Reports surgical fusion of a metacarpophalangeal joint when the surgeon permanently stabilizes a finger or thumb knuckle.
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.
CMS billing rules for 26516
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU7.14 · 33%
- Practice expense (office) RVU12.97 · 60%
- Malpractice RVU1.37 · 6%
853
Medicare services in 2024 · #3092 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.
26516 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
Code 26531 describes MCP arthroplasty with an implant; 26516 is for MCP fusion, with or without fixation.
No office rate
Code 26520 releases an MCP contracture. It does not describe permanently fusing the joint.
No office rate
Both are nearby MCP fusion codes. Use the complete code descriptors and operative documentation to distinguish the specific service reported.
Compare 26516 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$656.84
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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 26516 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
2,625
- Code
- 26516
- Physician work
- 7.14
- Practice expense
- 12.97
- Malpractice
- 1.37
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.14 | × 1.000 | 7.1400 |
| Practice expense | 12.97 | × 0.909 | 11.7897 |
| Malpractice | 1.37 | × 0.537 | 0.7357 |
| Total RVUs | 19.6654 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$656.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.14 | 1 |
| Practice expense | 12.97 | 0.909 |
| Malpractice | 1.37 | 0.537 |
(7.14 × 1 + 12.97 × 0.909 + 1.37 × 0.537) × $33.4009 = $656.84
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.
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 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.
2,62226502,,Hand tendon reconstruction,A,,7.13,13.68,NA,13.68,,1.50,22.31,22.31,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62326508,,Release thumb contracture,A,,6.03,12.13,NA,12.13,,1.04,19.20,19.20,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62426510,,Thumb tendon transfer,A,,5.46,12.28,NA,12.28,,1.05,18.79,18.79,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62526516,,Fusion of knuckle joint,A,,7.14,12.97,NA,12.97,,1.37,21.48,21.48,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62626517,,Fusion of knuckle joints,A,,8.85,14.58,NA,14.58,,1.88,25.31,25.31,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62726518,,Fusion of knuckle joints,A,,9.04,14.64,NA,14.64,,1.92,25.60,25.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62826520,,Release knuckle contracture,A,,5.33,13.73,NA,13.73,,1.02,20.08,20.08,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780