No office rate
26540 describes collateral-ligament repair without graft-based work. Choose 26541 when the documented procedure includes the graft-based repair represented by that code.
On this page
CMS RVU26D · Effective 2026-10-01
26540 Ligament repair Medicare reimbursement rates in Vermont
Reports operative repair of a collateral ligament at a finger or thumb MCP or IP joint, such as repair of an injured thumb MCP ligament. Compare 26540 office and facility rates across CMS payment localities in Vermont.
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 26540 in Vermont?
Vermont 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
$654.69
1 of 1 localities have a supported rate.
Payment area: Vermont
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 26540: Collateral ligament repair of hand joint
Reports operative repair of a collateral ligament at a finger or thumb MCP or IP joint, such as repair of an injured thumb MCP ligament.
This surgery repairs a collateral ligament that stabilizes a metacarpophalangeal (MCP) or interphalangeal (IP) joint in the hand. A typical example is direct repair of a torn thumb MCP collateral ligament after an injury; the service may also involve another finger joint. An orthopedic or hand surgeon performs the operation, usually in an operating room, using the operative approach and repair technique appropriate to the ligament injury.
Report the code when the surgeon repairs the joint’s collateral ligament without the graft-based work represented by related codes. The operative report should identify the joint and side, describe the ligament injury, and document the repair performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur 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. Assistant-at-surgery and co-surgeon payment require supporting documentation; team surgery is not permitted.
CMS billing rules for 26540
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.44 · 32%
- Practice expense (office) RVU12.66 · 62%
- Malpractice RVU1.24 · 6%
2.2K
Medicare services in 2024 · #2394 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.
26540 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This is a related graft-based hand-joint repair code. Distinguish it from 26540 by the graft work documented in the operative report.
No office rate
26545 describes finger-joint reconstruction, rather than the collateral-ligament repair represented by 26540. Select based on the procedure actually performed.
Compare 26540 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
Vermont →
Office / nonfacility
Unavailable
Facility
$654.69
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 26540 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,634
- Code
- 26540
- Physician work
- 6.44
- Practice expense
- 12.66
- Malpractice
- 1.24
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.44 | × 1.000 | 6.4400 |
| Practice expense | 12.66 | × 0.990 | 12.5334 |
| Malpractice | 1.24 | × 0.506 | 0.6274 |
| Total RVUs | 19.6008 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$654.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.44 | 1 |
| Practice expense | 12.66 | 0.99 |
| Malpractice | 1.24 | 0.506 |
(6.44 × 1 + 12.66 × 0.99 + 1.24 × 0.506) × $33.4009 = $654.69
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.
26540 billing questions
When should 26540 be chosen over a graft-based repair code?
Use 26540 for repair of the collateral ligament without the graft-based work described by 26541 or 26542. The operative report should support the technique actually performed.
Can this code be reported for a thumb MCP ligament repair?
Yes. Direct repair of an injured thumb MCP collateral ligament is a typical example; document the joint, side, injury, and repair.
Should modifier 50 be used for repairs on both hands?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant surgeon payable?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeon payment also requires supporting documentation.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session 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.
2,63126531,,Revise knuckle with implant,A,,7.93,8.19,NA,8.19,,1.49,17.61,17.61,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63226535,,Revise finger joint,A,,5.27,6.30,NA,6.30,,1.00,12.57,12.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63326536,,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817