Billing code 26861: Finger joint fusionMedicare rate & RVUs in Washington
Reports fusion of an additional finger interphalangeal joint during the same operative session as the primary finger joint fusion.
CMS doesn’t publish an office rate for 26861 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 26861 covers
A hand surgeon fuses an additional interphalangeal joint in a finger by preparing the joint surfaces and stabilizing them so the bones can unite. The service may involve a proximal or distal interphalangeal joint; the thumb is coded separately. Internal fixation may be used. This add-on represents another finger joint treated during the operative session, not a later fusion or a separate visit.
Report 26861 with the primary finger interphalangeal fusion code, 26860, for each additional joint treated. The operative report should identify the digit and joint, document the fusion work, and distinguish each additional joint from the one represented by the primary code. CMS classifies 26861 as an add-on: it is billed only with a primary procedure and paid within that procedure’s global period. When autogenous bone graft is used for the additional joint, compare the graft-specific add-on code instead.
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 26861 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $85.86 |
| Seattle (King Cnty) | Unavailable | $91.85 |
How the 26861 rate is calculated
Each of 26861’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 · 26861
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.70Practice expense 0.56Malpractice 0.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26861
The CMS indicators that decide how 26861 is paid alongside other services.
CMS payment indicators · 26861
Finger joint fusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
26861 compared with similar codes
Compare codes
26861 vs 26860 vs 26863 vs 26850: national Medicare rates
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How to choose
- 26860Finger joint fusion
- 26860 reports the primary finger interphalangeal joint fusion. Use 26861 for each additional finger interphalangeal joint fused in that operative session.
- 26863Finger joint fusion
- 26863 is the additional-joint counterpart when autogenous bone graft is used; 26861 is for the additional fusion without that graft.
- 26850Knuckle fusion
- 26850 concerns a finger metacarpophalangeal joint. Code 26861 concerns an additional interphalangeal joint.
26861 billing questions
When should 26861 be reported instead of 26860?
Use 26860 for the primary finger interphalangeal joint fusion. Report 26861 for each additional finger interphalangeal joint fused in the same operative session.
Can 26861 be billed by itself?
No. It is an add-on code and must be reported with the primary procedure, 26860. CMS payment is within that primary procedure’s global period.
How is 26861 different from 26863?
Both represent an additional finger interphalangeal joint fusion. Use 26863 when the additional joint fusion includes autogenous bone graft; 26861 is the corresponding option without that graft.
What should the operative note identify?
Document the digit and interphalangeal joint fused, the fusion work performed, and which joint is the additional one. The note should support the primary procedure and each separately treated additional joint.
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
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