Open exploration and treatment of a finger joint (proximal or middle interphalangeal, or metacarpophalangeal) via arthrotomy, including irrigation, debridement, or removal of loose bodies as indicated.

Verified May 8, 2026 · 5 sources ↓

Medicare: $387.78
Work RVU: 4.36
Global, days: 90
Region: Hand

Drawn from CMSNIH

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify which finger joint was treated (PIP, DIP, or MCP) and which digit (thumb through small finger) using standard anatomical terminology.
Operative note must document the surgical approach — dorsal, volar, or lateral — by name; 'standard approach' is an audit flag.
Describe all intraoperative findings (synovitis, purulence, loose bodies, cartilage condition) and what was done to address them.
Document the indication driving open arthrotomy rather than closed or arthroscopic management (e.g., failed aspiration, septic joint, prior surgery).
Record intraoperative cultures or specimens if obtained, as these support medical necessity for infectious indications.
Note whether the procedure was performed under tourniquet, and document tourniquet time if applicable.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 26080 covers open arthrotomy of a finger joint — PIP, DIP, or MCP — performed to explore, irrigate, debride, or otherwise treat the joint space. It is the open counterpart to diagnostic or minor arthroscopic approaches and is used for septic arthritis, loose body removal, or joint inspection when closed or arthroscopic management is insufficient. The code carries a 90-day global period, meaning all routine post-op care through day 90 is bundled — separate E/M visits during that window require modifier 24 or 25 to indicate an unrelated or distinct reason.

Finger-specific modifier rules apply. NCCI policy requires digit-level modifiers (FA, F1–F9) to identify which finger was treated. MUE values for many finger procedures are set to one per unit because of this modifier-based reporting structure. If the same procedure is performed on multiple fingers in the same session, report each on a separate claim line with the appropriate finger modifier. Bilateral reporting follows standard CMS rules: modifier 50 on a single line for physician claims, and separate LT/RT lines for ASC claims.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (4.36) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.61) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	4.36
Practice expense RVU	6.41
Malpractice RVU	0.84
Total RVU	11.61
Medicare national rate	$387.78
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$387.78
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 26080 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or ambiguous digit identifier — claim lacks the FA/F1–F9 modifier required to specify which finger was treated.
Medical necessity not established — operative note does not document failed conservative management or a diagnosis that supports open versus closed treatment.
Unbundling conflict — separately billing an arthrotomy or synovectomy code that is already included in the 26080 global package.
Global period overlap — post-op E/M visit billed without modifier 24 when unrelated to the index procedure, or without modifier 25 on same-day E/M.
Site-of-service mismatch — procedure billed under a facility fee schedule inconsistent with the place of service reported on the claim.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Which digit modifiers are required with CPT 26080?

Use FA for the thumb, F1–F4 for the left hand fingers (index through small), and F5–F9 for the right hand fingers (index through small). NCCI policy ties MUE limits for finger procedures to these modifiers, so omitting them is a direct path to a claim denial or MUE edit.

02If I perform 26080 on two different fingers during the same session, how do I report it?

Report 26080 on two separate claim lines, each with the appropriate digit modifier (e.g., F2 and F3). List the higher-complexity or primary procedure first. Add modifier 51 on the second line for physician claims to indicate multiple procedures. The 90-day global applies independently to each digit.

03Is a same-day E/M billable with 26080?

Only if the E/M represents a significant, separately identifiable service. Append modifier 25 to the E/M code and document the distinct decision-making or medical issue that went beyond the pre-op assessment for the arthrotomy.

04How does bilateral reporting differ between physician and ASC claims?

For physician (CMS-1500) claims, report 26080 with modifier 50 on a single line. For ASC claims, report two lines — one with modifier LT and one with RT, each with one unit of service. This is a hard CMS requirement, not a payer option.

05What separates 26080 from 26075 and how do I choose the right code?

Both codes describe open finger joint exploration and treatment but cover different joints in the finger's anatomical hierarchy. Review the CPT descriptor hierarchy and the AAOS Global Service Data to confirm which specific joint level maps to each code before billing. Picking the wrong code based on joint level is a common upcoding or downcoding error that surfaces on audit.

06Can I bill separately for intraoperative cultures taken during 26080?

The collection of intraoperative specimens is generally considered integral to the surgical procedure and not separately billable. The lab processing and interpretation of those cultures may be separately reportable, but the act of obtaining them during 26080 is bundled into the global service.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

The Mira AI Scribe captures the specific joint level (PIP, DIP, or MCP), the digit by name and number, the surgical approach used, all intraoperative findings, and every intervention performed (irrigation volume, debridement extent, loose body removal). This prevents the two most common denial triggers for 26080: a missing digit-level identifier and an operative note that documents findings without linking them to a documented surgical action.

See how Mira captures CPT 26080 documentation