$331.20
Choose 26600 for closed treatment without manipulation. This code describes open treatment of the fracture.
On this page
CMS RVU26D · Effective 2026-10-01
26615 Metacarpal fracture Medicare reimbursement rates in Vermont
Report this service for open treatment of a metacarpal fracture, with internal fixation when performed, for each metacarpal bone treated. Compare 26615 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 26615 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
$523.10
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.
Orthopedic surgery
About 26615: Open metacarpal fracture treatment
Report this service for open treatment of a metacarpal fracture, with internal fixation when performed, for each metacarpal bone treated.
This service covers surgical exposure and direct treatment of a fractured metacarpal, with internal fixation when performed. It is typically performed by an orthopedic or hand surgeon in an operating room when the fracture requires open treatment rather than closed reduction or percutaneous fixation. The code is reported for each metacarpal bone treated; the operative report should identify the involved bone and document the open approach, reduction, and fixation performed.
The code has a 90-day global period, including 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26615
- 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 RVU6.89 · 42%
- Practice expense (office) RVU8.18 · 50%
- Malpractice RVU1.33 · 8%
2.7K
Medicare services in 2024 · #2253 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.
26615 compared with similar codes
Office rates for Vermont, from the same CMS release.
$363.79
Choose 26605 when the fracture is treated closed with manipulation. This code applies when treatment is open.
No office rate
Choose 26608 for percutaneous skeletal fixation. This code is for open treatment, including internal fixation when performed.
Compare 26615 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
$523.10
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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 26615 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,662
- Code
- 26615
- Physician work
- 6.89
- Practice expense
- 8.18
- Malpractice
- 1.33
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.89 | × 1.000 | 6.8900 |
| Practice expense | 8.18 | × 0.990 | 8.0982 |
| Malpractice | 1.33 | × 0.506 | 0.6730 |
| Total RVUs | 15.6612 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$523.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.89 | 1 |
| Practice expense | 8.18 | 0.99 |
| Malpractice | 1.33 | 0.506 |
(6.89 × 1 + 8.18 × 0.99 + 1.33 × 0.506) × $33.4009 = $523.10
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.
26615 billing questions
When should this code be chosen over closed-treatment codes?
Use it when the metacarpal fracture is treated through an open surgical approach. Closed treatment without manipulation or with manipulation is represented by different codes.
Is internal fixation included?
Yes. The service includes internal fixation when performed as part of the open fracture treatment.
How many units should be reported when multiple metacarpals are treated?
The code is reported for each metacarpal bone treated. Document the specific bone or bones addressed in the operation.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
What postoperative care is included?
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 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.
2,65926605,,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
2,66326641,,Treat thumb dislocation,A,,4.03,9.16,,6.61,,0.86,14.05,11.50,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66426645,,Treat thumb fracture,A,,4.47,9.05,,6.30,,0.96,14.48,11.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66526650,,Treat thumb fracture,A,,5.22,7.83,NA,7.83,,1.04,14.09,14.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,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