Billing code 26844: Hand joint fusionMedicare rate & RVUs in Virginia
Reports fusion of a carpometacarpal joint other than the thumb using the patient’s own bone graft to treat a painful or unstable joint.
CMS doesn’t publish an office rate for 26844 in Virginia.
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 26844 covers
This service fuses a carpometacarpal joint in the hand other than the thumb, using bone graft taken from the patient. It may be performed by a hand or orthopedic surgeon for a painful, unstable, or damaged joint, including after trauma or with arthritic change. The operative work addresses the selected joint between a carpal bone and its metacarpal; it is not a fusion of a finger joint or the thumb’s carpometacarpal joint.
Report this code when the operative record supports fusion of a nonthumb carpometacarpal joint and use of autogenous bone graft. Document the specific joint, the indication, the fusion work, and the graft source; graft procurement is included in this service. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of 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 for this code. Assistant-at-surgery payment may be available; 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.
Where 26844 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $950.03 |
| Virginia | Unavailable | $814.17 |
How the 26844 rate is calculated
Each of 26844’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 · 26844
RVUs × geographic indexes × conversion factor
Work8.76
8.76 RVUs× 1.000 GPCI
Practice expense14.55
14.55 RVUs× 1.000 GPCI
Malpractice1.86
1.86 RVUs× 1.000 GPCI
Adjusted RVUs
25.1700
Conversion factor
$33.4009
Medicare rate
$840.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26844
26844 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26844
Hand joint fusion
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 26844
Hand joint fusion
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 51 · payment effect
With and without the modifier
26844 without 51 · national facility
$840.70
Hand joint fusion
26844-51 · Second procedure: 50%
$420.35
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26844 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26843Hand joint fusion
- Choose 26844 when the nonthumb carpometacarpal fusion uses autogenous bone graft. Code 26843 describes the corresponding fusion without that graft distinction.
- 26842Thumb fusion
- Both involve carpometacarpal fusion with graft, but 26842 is for the thumb; 26844 is for a carpometacarpal joint other than the thumb.
- 26850Knuckle fusion
- 26850 is for fusion at a metacarpophalangeal joint, the knuckle where a metacarpal meets a finger. 26844 is for a carpometacarpal joint.
- 26860Finger joint fusion
- 26860 addresses fusion of a finger joint. Use 26844 for a nonthumb carpometacarpal joint fused with autogenous graft.
26844 billing questions
How is this different from 26843?
Both address a carpometacarpal joint other than the thumb. Use 26844 when autogenous bone graft is used; 26843 is the corresponding fusion code without graft.
Can the bone graft harvest be billed separately?
The graft procurement is included in 26844. Document the graft source and its use in the fusion.
Can modifier 50 be used for two-sided hand surgery?
No. CMS identifies modifier 50 as inappropriate for this code’s descriptor or anatomy.
What postoperative care is included?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires 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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