Billing code 26665: Thumb fracture-dislocation repairMedicare rate & RVUs in Utah
Report this service for operative treatment of a fracture-dislocation at the thumb carpometacarpal joint, with fixation when performed.
CMS doesn’t publish an office rate for 26665 in Utah.
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 26665 covers
This code covers open surgical treatment of a fracture-dislocation where the base of the thumb metacarpal is displaced at its joint with the trapezium. An orthopedic or hand surgeon typically exposes and reduces the joint and stabilizes the injury as needed, often in an operating room. The key distinction is a thumb carpometacarpal fracture-dislocation treated through an open approach, rather than an isolated thumb metacarpal fracture or a dislocation without fracture.
Choose the code based on the documented injury and operative approach. The operative report should identify the fracture-dislocation, the thumb carpometacarpal joint, the open reduction, and any fixation performed. Medicare 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeon payment requires 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.
26665 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $556.83 |
How the 26665 rate is calculated
Each of 26665’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 · 26665
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.74Practice expense 8.24Malpractice 1.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26665
26665 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26665
Thumb fracture-dislocation repair
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 26665
Thumb fracture-dislocation repair
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
26665 without 50 · national facility
$577.84
Thumb fracture-dislocation repair
26665-50 · Bilateral: 150%
$866.76
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).
26665 compared with similar codes
Compare codes
26665 vs 26645 vs 26650 vs 26641 vs 26615: national Medicare rates
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How to choose
- 26645Thumb fracture
- Use 26645 for closed treatment of a thumb carpometacarpal fracture-dislocation without manipulation; use 26665 when the fracture-dislocation is treated through an open approach.
- 26650Thumb fracture-dislocation
- Code 26650 describes closed treatment with manipulation. Open operative treatment of the thumb carpometacarpal fracture-dislocation is reported with 26665.
- 26641Thumb dislocation
- Code 26641 is for thumb carpometacarpal dislocation without a fracture. This code requires a fracture-dislocation treated openly.
- 26615Metacarpal fracture
- Code 26615 applies to open treatment of a metacarpal fracture; 26665 applies when the thumb carpometacarpal joint is involved in a fracture-dislocation.
26665 billing questions
When should this code be chosen instead of 26645 or 26650?
Use this code for open surgical treatment of a thumb carpometacarpal fracture-dislocation. Codes 26645 and 26650 describe closed treatment, distinguished by whether manipulation is performed.
How does this differ from open treatment of a thumb metacarpal fracture?
This code is for a fracture-dislocation involving the thumb carpometacarpal joint. Code 26615 is for open treatment of a metacarpal fracture and is not the choice for that joint fracture-dislocation.
Can fixation be reported separately?
Fixation performed as part of the open treatment is included in this service. The operative note should describe the reduction and any stabilization performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures or bilateral treatment handled?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are reduced by the standard multiple-procedure rule. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only with supporting documentation; team surgery is 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 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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