Billing code 26705: Knuckle reductionMedicare rate & RVUs in Washington
Reports closed reduction of a single metacarpophalangeal joint dislocation when manipulation is performed under anesthesia, rather than simple positioning or fixation.
Medicare pays $499.97–$561.87 for 26705 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 26705 covers
This service is a closed reduction of a dislocated metacarpophalangeal (MCP) joint—the knuckle where a finger meets the hand. The clinician manipulates the joint back into alignment without opening the joint or using percutaneous pins. It is typically performed by an orthopedic or hand surgeon, sometimes in an emergency or procedure setting, when reduction requires anesthesia. The code applies to one MCP joint; a dislocation at a finger’s interphalangeal joint is a different anatomic service.
The record should identify the affected MCP joint, document the dislocation, the manipulative reduction, and the use of anesthesia. This is a major procedure with 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 26705 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $499.97 | $402.90 |
| Seattle (King Cnty) | $561.87 | $448.76 |
How the 26705 rate is calculated
Each of 26705’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 · 26705
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.27Practice expense 9.45Malpractice 0.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26705
26705 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26705
Knuckle reduction
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 26705
Knuckle reduction
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
26705 without 51 · national office
$488.66
Knuckle reduction
26705-51 · Second procedure: 50%
$244.33
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%).
26705 compared with similar codes
Compare codes
26705 vs 26700 vs 26706 vs 26715 vs 26775: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26700MCP dislocation
- Choose 26705 for a single MCP dislocation requiring manipulative reduction under anesthesia; 26700 represents closed treatment without manipulation.
- 26706Knuckle dislocation
- 26706 is for percutaneous skeletal fixation of an MCP dislocation. Use 26705 when the closed reduction does not include percutaneous fixation.
- 26715Knuckle dislocation
- 26715 describes open treatment of an MCP dislocation. 26705 is for closed manipulative reduction.
- 26775Finger dislocation
- 26775 concerns an interphalangeal joint dislocation treated with manipulation requiring anesthesia; 26705 concerns the MCP joint.
26705 billing questions
How does this differ from 26700?
26705 is for a single MCP dislocation reduced with manipulation requiring anesthesia. 26700 is the related code for closed treatment without manipulation.
When should 26706 be considered instead?
Use 26706 when percutaneous skeletal fixation is performed for the MCP dislocation. This code describes closed manipulative reduction without percutaneous fixation.
Can modifier 50 be used for dislocations on both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are 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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