Billing code 26715: Knuckle dislocationMedicare rate & RVUs in Washington
Open reduction of a single metacarpophalangeal joint dislocation, typically when closed reduction fails or soft tissue blocks alignment.
CMS doesn’t publish an office rate for 26715 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 26715 covers
A hand or orthopedic surgeon uses an open approach to restore alignment of a dislocated metacarpophalangeal joint. This may be needed when a closed reduction cannot restore the joint, such as when soft tissue is trapped between the joint surfaces, or when the surgeon determines open treatment is necessary. The procedure is commonly performed in an operating room for a traumatic knuckle dislocation.
Report this code for open treatment of one MCP joint dislocation; distinguish it from closed reduction and percutaneous fixation. The operative note should identify the joint and digit, describe the open reduction, and document any fixation. Internal fixation, when performed, is included. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 multiple procedure reduction. Bilateral adjustment is not appropriate. 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 26715 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $551.97 |
| Seattle (King Cnty) | Unavailable | $610.27 |
How the 26715 rate is calculated
Each of 26715’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 · 26715
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.85Practice expense 8.15Malpractice 1.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26715
26715 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26715
Knuckle dislocation
| 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 · 26715
Knuckle dislocation
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
26715 without 51 · national facility
$545.10
Knuckle dislocation
26715-51 · Second procedure: 50%
$272.55
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%).
26715 compared with similar codes
Compare codes
26715 vs 26700 vs 26705 vs 26706 vs 26785: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26700MCP dislocation
- 26700 is closed treatment of an MCP dislocation without manipulation. Use 26715 when the surgeon treats the joint through an open approach.
- 26705Knuckle reduction
- 26705 covers closed treatment with manipulation requiring anesthesia; 26715 covers open treatment of the MCP dislocation.
- 26706Knuckle dislocation
- 26706 uses percutaneous skeletal fixation. 26715 is for open treatment, with internal fixation included when performed.
- 26785Finger dislocation
- 26785 is open treatment of a dislocation at a finger interphalangeal joint. 26715 is for an MCP joint.
26715 billing questions
How does this differ from 26705?
26705 is for closed treatment with manipulation requiring anesthesia. Report 26715 when the dislocation is treated through an open approach.
Can internal fixation be reported separately?
No. Internal fixation, when performed as part of the open treatment, is included in 26715.
When is 26706 a better fit?
26706 describes percutaneous skeletal fixation of an MCP dislocation. Use 26715 for open treatment.
What documentation supports 26715?
Document the affected MCP joint and digit, the dislocation, the open approach and reduction, and any fixation performed.
Can modifier 50 be used for dislocations on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 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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