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26850 Fusion of knuckle

What 26850 is

CMS fee schedule short descriptor: Fusion of knuckle.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 26850 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)6.9612.871.3221.15$706.43
Facility (hospital, ASC)6.9612.871.3221.15$706.43

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

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Medically Unlikely Edit (MUE)

Medicare caps 26850 at 5 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 26850? These codes are bundled into it

26850 is a Column 1 code in 294 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01810Anes px nrv musc f/arm wrst0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0490TRegn cell tx scldr h mlt inj1 - modifier may bypassCheck pair
0566TAutol cell implt adps njx1 - modifier may bypassCheck pair
0594TOsteot hum xtrnl lngth dev1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0718TAdrc ther prtl rc tear njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair

Showing 30 of 294 column 2 codes. Use the pair checker for any specific combination.

26850 is bundled into these codes

26850 appears as a Column 2 code in 8 active edits. Reported with one of these Column 1 codes on the same date of service, 26850 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11010Debride skin at fx site1Check pair
11011Debride skin musc at fx site1Check pair
20808Replantation hand complete1Check pair
20816Replantation digit complete1Check pair
20822Replantation digit complete1Check pair
20824Replantation thumb complete1Check pair
20827Replantation thumb complete1Check pair
26852Fusion of knuckle with graft1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.