$325.59
Choose 26600 when closed treatment does not involve manipulation; 26605 requires a reduction maneuver.
On this page
CMS RVU26D · Effective 2026-10-01
26605 Metacarpal fracture Medicare reimbursement rates in Utah
Report this service when a clinician reduces a metacarpal fracture by manipulation without opening the fracture site or using percutaneous fixation. Compare 26605 office and facility rates across CMS payment localities in Utah.
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 26605 in Utah?
Utah 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
$358.90
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$298.30
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Orthopedic surgery
About 26605: Metacarpal fracture closed reduction
Report this service when a clinician reduces a metacarpal fracture by manipulation without opening the fracture site or using percutaneous fixation.
An orthopedic or hand surgeon, and sometimes an emergency physician, manipulates a fractured metacarpal to restore alignment without surgically exposing the fracture. The clinician typically confirms the reduction with imaging and immobilizes the hand in a splint or cast. Common clinical settings include an office, emergency department, or facility where the fracture can be reduced and stabilized without open surgery.
Select this code when the physician performs closed reduction; a fracture treated without manipulation belongs to a different code. Document the metacarpal treated, fracture findings, the reduction maneuver and resulting alignment, and immobilization. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26605
- 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 RVU2.95 · 26%
- Practice expense (office) RVU7.71 · 68%
- Malpractice RVU0.61 · 5%
870
Medicare services in 2024 · #3066 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.
26605 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Both concern metacarpal fractures, but 26607 represents a different treatment specification. Verify the method and circumstances documented before choosing between them.
No office rate
26608 describes percutaneous skeletal fixation. Use 26605 for closed manipulation without that fixation approach.
No office rate
26615 is for open fracture treatment. This code describes reduction without surgically exposing the fracture.
Compare 26605 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
Utah →
Office / nonfacility
$358.90
Facility
$298.30
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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 26605 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,659
- Code
- 26605
- Physician work
- 2.95
- Practice expense
- 7.71
- Malpractice
- 0.61
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.95 | × 1.000 | 2.9500 |
| Practice expense | 7.71 | × 0.940 | 7.2474 |
| Malpractice | 0.61 | × 0.898 | 0.5478 |
| Total RVUs | 10.7452 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$358.90
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.95 | 1 |
| Practice expense | 7.71 | 0.94 |
| Malpractice | 0.61 | 0.898 |
(2.95 × 1 + 7.71 × 0.94 + 0.61 × 0.898) × $33.4009 = $358.90
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.95 | 1 |
| Practice expense | 5.78 | 0.94 |
| Malpractice | 0.61 | 0.898 |
(2.95 × 1 + 5.78 × 0.94 + 0.61 × 0.898) × $33.4009 = $298.30
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.
26605 billing questions
How does this differ from 26600?
Use 26605 when the physician manipulates the fracture to restore alignment. Code 26600 describes closed treatment without manipulation.
What documentation supports reporting 26605?
Record the metacarpal involved, the fracture and alignment findings, the reduction maneuver, and the post-reduction result. Include the immobilization used.
Is routine follow-up separately reported during the global period?
Related postoperative care is included in the 90-day global period, along with the day-before preoperative visit.
Can modifier 50 be used for fractures in both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
2,65626593,,Release muscles of hand,A,,5.36,12.63,NA,12.63,,1.04,19.03,19.03,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65726596,,Excision constricting tissue,A,,8.91,12.91,NA,12.91,,1.91,23.73,23.73,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65826600,,Treat metacarpal fracture,A,,2.54,7.20,,5.97,,0.49,10.23,9.00,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,65926605,,Treat metacarpal fracture,A,,2.95,7.71,,5.78,,0.61,11.27,9.34,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66026607,,Treat metacarpal fracture,A,,5.34,8.41,NA,8.41,,1.14,14.89,14.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66126608,,Treat metacarpal fracture,A,,5.41,7.42,NA,7.42,,1.07,13.90,13.90,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66226615,,Treat metacarpal fracture,A,,6.89,8.18,NA,8.18,,1.33,16.40,16.40,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985