No office rate
26862 represents the primary grafted interphalangeal joint fusion. Use 26863 for each additional grafted joint in the same operative service.
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CMS RVU26D · Effective 2026-10-01
26863 Finger joint fusion Medicare reimbursement rates in Vermont
Reports grafted fusion of each additional finger interphalangeal joint performed with a primary joint fusion, when the operative documentation supports the extra joint. Compare 26863 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 26863 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
$179.75
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 26863: Additional finger joint fusion with bone graft
Reports grafted fusion of each additional finger interphalangeal joint performed with a primary joint fusion, when the operative documentation supports the extra joint.
This add-on represents fusion of an additional interphalangeal joint of a finger using autogenous bone graft. Hand or orthopedic surgeons may perform it when more than one finger joint requires stabilization, such as for painful joint disease or deformity. The procedure is generally performed in an operating room; the operative report should identify the joints fused and document graft use.
Report 26863 with the primary grafted joint-fusion procedure, 26862, for each additional joint treated. The operative note should distinguish the primary joint from each additional joint and support the number of units billed. This code is an add-on, not a stand-alone service, and payment falls within the primary procedure’s global period.
CMS billing rules for 26863
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU3.79 · 66%
- Practice expense (office) RVU1.25 · 22%
- Malpractice RVU0.70 · 12%
140
Medicare services in 2024 · #4607 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.
26863 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
26861 represents an additional interphalangeal joint fusion without autogenous graft; 26863 is for an additional joint treated with graft.
No office rate
26860 is a primary interphalangeal joint fusion without the graft distinction. It does not represent an additional grafted joint.
Compare 26863 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
$179.75
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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 26863 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,701
- Code
- 26863
- Physician work
- 3.79
- Practice expense
- 1.25
- Malpractice
- 0.70
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.79 | × 1.000 | 3.7900 |
| Practice expense | 1.25 | × 0.990 | 1.2375 |
| Malpractice | 0.70 | × 0.506 | 0.3542 |
| Total RVUs | 5.3817 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$179.75
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.79 | 1 |
| Practice expense | 1.25 | 0.99 |
| Malpractice | 0.7 | 0.506 |
(3.79 × 1 + 1.25 × 0.99 + 0.7 × 0.506) × $33.4009 = $179.75
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.
26863 billing questions
Which primary code must accompany 26863?
Report 26863 with 26862, the primary finger interphalangeal joint fusion code with autogenous graft. It is not reported by itself.
How many units should be reported?
Report one unit for each additional interphalangeal joint fused beyond the primary joint. The operative note should identify each joint treated.
When is 26861 a better fit?
Use 26861 for an additional interphalangeal joint fusion when the service does not include autogenous bone graft. Code 26863 is the grafted additional-joint counterpart.
Is graft harvesting separately represented by 26863?
The documentation should establish that autogenous graft was used for the additional joint. Report 26863 with 26862; payment is within the primary procedure’s global period.
What documentation supports reporting an additional joint?
The operative report should name the primary fused joint and each additional interphalangeal joint, describe the fusion performed, and support autogenous graft use.
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.
2,69826860,,Fusion of finger joint,A,,4.76,12.49,NA,12.49,,0.91,18.16,18.16,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,69926861,,Fusion of finger jnt add-on,A,,1.70,0.56,NA,0.56,,0.34,2.60,2.60,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70026862,,Fusion/graft of finger joint,A,,7.37,13.32,NA,13.32,,1.39,22.08,22.08,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70126863,,Fuse/graft added joint,A,,3.79,1.25,NA,1.25,,0.70,5.74,5.74,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70226910,,Amputate metacarpal bone,A,,7.60,13.08,NA,13.08,,1.49,22.17,22.17,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70326951,,Amputation of finger/thumb,A,,5.89,13.88,NA,13.88,,1.17,20.94,20.94,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70426952,,Amputation of finger/thumb,A,,6.32,12.44,NA,12.44,,1.23,19.99,19.99,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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