Soft tissue repair · Hand

26340

Manipulation of a finger joint performed under anesthesia to restore range of motion

Verified May 8, 2026 · 5 sources ↓

Medicare
$365.41
Total RVUs
10.94
Global, days
90
Region
Hand
Drawn from CMSMdclarityAAPCFindacode

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(s) and joint(s) were manipulated (e.g., right long finger PIP joint)
  • Document the type of anesthesia used and the provider administering it
  • Record pre- and post-manipulation range of motion measurements in degrees
  • State the clinical indication — e.g., post-traumatic stiffness, post-surgical adhesions, Dupuytren's recurrence
  • Note any conservative treatment failures prior to scheduling manipulation under anesthesia
  • Operative note must name the facility setting (OR, procedure room, ASC) — not an office encounter

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 26340 covers closed manipulation of a finger joint — typically a PIP or MCP joint — performed under anesthesia (general, regional, or monitored anesthesia care) to break up adhesions and restore motion. The anesthesia component is what distinguishes this from office-based manipulation; the procedure requires a formal operative or procedure suite setting and a separate anesthesia provider or documented MAC administration.

The code carries a 90-day global period. That window covers the day-before visit, the procedure itself, and all routine follow-up through day 90 — including postoperative hand therapy coordination and routine check visits. Any E/M service within that window for an unrelated condition requires modifier 24; a significant, separately identifiable E/M on the day of surgery requires modifier 25.

This code is most commonly billed by orthopedic surgeons and hand surgeons, typically for post-traumatic or post-surgical finger stiffness, Dupuytren's contracture recurrence, or adhesive capsulitis of the finger. Laterality modifiers (LT/RT) are expected when a single finger on one hand is treated; if multiple fingers are manipulated in the same session, document each digit individually — payers may scrutinize units billed without per-digit operative note documentation.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU2.73
Practice expense RVU7.71
Malpractice RVU0.5
Total RVU10.94
Medicare national rate$365.41
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$365.41
HOPD (APC 5112)
Hospital outpatient department
$1,642.82
ASC (PI G2)
Ambulatory surgical center (freestanding)
$872.87

Common denial reasons

The recurring reasons claims for CPT 26340 get rejected.

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

  • Missing or inadequate documentation of anesthesia type and provider — payers may downcode to a non-anesthesia manipulation code
  • Laterality modifier (LT or RT) absent, triggering automated claim suspension or rejection
  • Medical necessity not established — no documented failure of conservative range-of-motion therapy before the procedure
  • E/M billed same-day without modifier 25, bundled into the global surgery payment
  • Incorrect units billed for multiple digits without per-digit operative note documentation supporting separate encounters

Frequently asked questions

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

01Does 26340 include the anesthesia charge, or is that billed separately?
The surgeon bills 26340 for the manipulation. The anesthesiologist or CRNA bills separately using the appropriate anesthesia CPT code. The '26340 with anesthesia' descriptor means anesthesia is required for the service — it does not bundle the anesthesia payment into the surgical code.
02Can I bill 26340 for multiple fingers manipulated in the same session?
Payer policies vary. Some allow separate units per digit with modifier 59 to distinguish each; others bundle all digits into a single unit. Document each digit's pre- and post-manipulation ROM separately in the operative note regardless of how units are billed. Check your specific payer policy before appending multiple units.
03What laterality modifier do I use, and is it required?
Use LT for left hand and RT for right hand. Most Medicare MACs and commercial payers require a laterality modifier on unilateral finger procedures. Missing it is a common automated rejection trigger.
04How does the 90-day global period affect post-op hand therapy referrals billed by the same practice?
The global period covers the operating surgeon's follow-up visits only. Separately billing hand therapy services provided by a therapist in the same practice is not bundled into the surgeon's global — those bill under the therapist's NPI with appropriate therapy codes. The surgeon's own follow-up E/M visits within 90 days are included in the global and cannot be separately billed without modifier 24 (unrelated condition).
05If the patient is returned to the OR within the 90-day global to repeat the manipulation, what modifier applies?
Use modifier 78 if the return manipulation is related to the original procedure — for example, re-manipulation for recurrent stiffness at the same joint. Use modifier 79 if the return procedure is unrelated. Do not invert these: 78 is for related, 79 is for unrelated.
06Can 26340 be billed with an E/M on the same date?
Only if the E/M is significant and separately identifiable from the pre-procedure assessment, and only with modifier 25 appended to the E/M code. A routine pre-op check immediately before manipulation does not qualify. Document the distinct medical decision-making in the E/M note.

Mira AI Scribe

Mira's AI scribe captures the specific digit and joint manipulated, pre- and post-procedure ROM measurements, anesthesia type and provider, clinical indication, and prior conservative treatment history — all from dictation. That documentation package directly prevents the two most common denial triggers: missing laterality detail and unsubstantiated medical necessity.

See how Mira captures CPT 26340 documentation

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