Billing code 26820: Thumb arthrodesisMedicare rate & RVUs in Texas
Reports surgical fusion of the thumb interphalangeal joint using bone graft, typically for painful instability, arthritis, or joint damage.
CMS doesn’t publish an office rate for 26820 in Texas.
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 26820 covers
The surgeon prepares the opposing surfaces of the thumb interphalangeal joint and joins them to create a stable fusion, using bone graft and fixation as needed. Hand or orthopedic surgeons typically perform this procedure in an operating room for problems such as painful arthritis, post-traumatic joint damage, or persistent instability. The graft supports fusion; the operative service includes obtaining an autogenous graft when one is used.
Report this code for fusion of the thumb interphalangeal joint with graft, not fusion of the thumb’s carpometacarpal or metacarpophalangeal joint. The operative report should identify the joint, the graft used and its source, and the fixation or fusion technique. CMS assigns a 90-day 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is 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 26820 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $835.72 |
| Beaumont | Unavailable | $766.60 |
| Brazoria | Unavailable | $799.00 |
| Dallas | Unavailable | $806.24 |
| Fort Worth | Unavailable | $802.19 |
| Galveston | Unavailable | $802.77 |
| Houston | Unavailable | $834.80 |
| Rest Of Texas | Unavailable | $783.81 |
How the 26820 rate is calculated
Each of 26820’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 · 26820
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.24Practice expense 14.38Malpractice 1.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26820
26820 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26820
Thumb arthrodesis
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 26820
Thumb arthrodesis
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
26820 without 50 · national facility
$813.98
Thumb arthrodesis
26820-50 · Bilateral: 150%
$1,220.97
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).
26820 compared with similar codes
Compare codes
26820 vs 26860 vs 26862 vs 26842: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26860Finger joint fusion
- Use 26860 for interphalangeal fusion of a finger without the thumb-and-graft combination described here.
- 26862Finger fusion
- Use 26862 for graft-assisted interphalangeal fusion of a finger; this code is for the thumb.
- 26842Thumb fusion
- Use 26842 when the fused joint is the thumb carpometacarpal joint, not the thumb interphalangeal joint.
26820 billing questions
How is this code distinguished from thumb CMC fusion?
This code is for fusion of the thumb interphalangeal joint with graft. Thumb CMC fusion targets the joint at the base of the thumb.
Is graft harvesting separately reported?
The service includes obtaining an autogenous graft when one is used. Document the graft and its source in the operative report.
What should the operative report document?
Identify the thumb interphalangeal joint, the reason for fusion, the graft used and its source, and the method of fixation or fusion.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays this procedure at 150%.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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