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
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 RVU | 2.73 |
| Practice expense RVU | 7.71 |
| Malpractice RVU | 0.5 |
| Total RVU | 10.94 |
| Medicare national rate | $365.41 |
| 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 | $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?
02Can I bill 26340 for multiple fingers manipulated in the same session?
03What laterality modifier do I use, and is it required?
04How does the 90-day global period affect post-op hand therapy referrals billed by the same practice?
05If the patient is returned to the OR within the 90-day global to repeat the manipulation, what modifier applies?
06Can 26340 be billed with an E/M on the same date?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 03mdclarity.comhttps://www.mdclarity.com/cpt-code/26340
- 04aapc.comhttps://www.aapc.com/codes/cpt-codes/26340
- 05findacode.comhttps://www.findacode.com/cpt/26340-cpt-code.html
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