Billing code 26565: Metacarpal osteotomyMedicare rate & RVUs in Washington
Reports surgical cutting and realignment of a metacarpal to correct a bone deformity, such as angular or rotational malalignment.
CMS doesn’t publish an office rate for 26565 in Washington.
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 26565 covers
A hand or orthopedic surgeon performs this osteotomy to change the alignment or shape of a metacarpal. It may be used for a structural deformity that interferes with hand position or function. The surgeon plans and makes a bone cut, then stabilizes the corrected position when needed. These procedures are commonly performed in a hospital outpatient department or ambulatory surgery center.
Select the code when the operative work is an osteotomy of a metacarpal for deformity correction; document the bone treated, the deformity, the corrective plan, and any fixation. CMS assigns 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 service. Assistant-at-surgery services may be paid; co-surgeons and team surgery are 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 26565 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $705.21 |
| Seattle (King Cnty) | Unavailable | $789.33 |
How the 26565 rate is calculated
Each of 26565’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 · 26565
RVUs × geographic indexes × conversion factor
Work6.74
6.74 RVUs× 1.000 GPCI
Practice expense12.62
12.62 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
20.6700
Conversion factor
$33.4009
Medicare rate
$690.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26565
26565 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26565
Metacarpal osteotomy
| 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) | 0 | Not permitted. |
| 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 · 26565
Metacarpal osteotomy
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
26565 without 51 · national facility
$690.40
Metacarpal osteotomy
26565-51 · Second procedure: 50%
$345.20
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%).
26565 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26567Finger osteotomy
- Use 26565 for an osteotomy of a metacarpal. Use 26567 for an osteotomy of a finger phalanx.
- 26568Bone lengthening
- Use 26568 when the procedure is metacarpal lengthening. Use 26565 for corrective metacarpal osteotomy when lengthening is not the defining objective.
- 26546Metacarpal repair
- Use 26546 for repair of metacarpal nonunion or malunion. Use 26565 for an osteotomy performed to correct a metacarpal deformity.
26565 billing questions
How is this different from a phalangeal osteotomy?
This code is for an osteotomy of a metacarpal, the long bone in the palm. billing code 26567 is for an osteotomy of a finger phalanx.
Is fixation separately reported when used?
Fixation used to hold the metacarpal in its corrected position is part of the osteotomy service. Document the fixation performed in the operative report.
When should a metacarpal nonunion repair code be considered instead?
Consider billing code 26546 when the operation repairs an established metacarpal nonunion or malunion. Use 26565 when the documented work is an osteotomy to correct a metacarpal deformity.
Can modifier 50 be used for osteotomies on both hands?
CMS identifies modifier 50 as inappropriate for this descriptor and anatomy. Do not use it to claim a bilateral adjustment 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 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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