Capsulodesis of the metacarpophalangeal joint(s) in two digits to correct instability by tightening and reattaching the joint capsule to the metacarpal and proximal phalanx.

Verified May 8, 2026 · 6 sources ↓

Medicare: $845.38
Total RVUs: 25.31
Global, days: 90
Region: Hand

Drawn from CMSFastrvuMdclarityAAPCEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the exact digits treated (e.g., index and long finger) — 'two digits' alone is insufficient for audit defense.
Document the indication: chronic MCP volar plate laxity, ulnar/radial deviation instability, or post-traumatic capsular insufficiency.
Describe the surgical approach and the specific capsular tissue incised, tensioned, and reattached, including fixation method.
Confirm intraoperative range of motion and stability testing post-repair.
Record laterality (left vs. right hand) and whether both hands were treated in the same session.
If upgrading to 26518, document all three or more digits treated with medical necessity for each.

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 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26517 describes capsulodesis performed on two digits at the metacarpophalangeal (MCP) joint level. The surgeon opens the joint capsule, tensions it, and secures it to the metacarpal and phalanx to restore volar or lateral stability. This is distinct from articular fusion (arthrodesis); the joint retains motion. Use 26516 for a single-digit capsulodesis and 26518 when three or more digits are addressed at the same operative session.

The code carries a 90-day global period. All routine post-op care, dressing changes, and follow-up visits through day 90 are bundled. Separate E/M services during that window require modifier 24 (unrelated) or 25 (significant, separate problem on the same day as a procedure). Pre-op evaluation the day before surgery is also included in the global.

Site of service matters here. HOPD and ASC payment rates differ substantially — see the Site of Service comparison table on this page. When the procedure is performed bilateral, append modifier 50 and verify the payer accepts bilateral billing on a single line vs. two separate lines with LT/RT.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.85
Practice expense RVU	14.58
Malpractice RVU	1.88
Total RVU	25.31
Medicare national rate	$845.38
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	$845.38
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 26517 get rejected.

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

Wrong code selected — 26516 (one digit) or 26518 (three+ digits) billed when digit count doesn't match the operative note.
Bundling with concurrent MCP arthroplasty or tendon procedures without adequate modifier and separate documentation supporting distinct work.
Modifier 50 rejected because payer requires LT/RT on separate lines rather than bilateral indicator on one line — confirm payer-specific bilateral billing rules.
Post-op E/M billed without modifier 24 or 25 during the 90-day global, triggering automatic denial.
Diagnosis code mismatch — instability or laxity ICD-10 not linked; vague codes like 'disorder of finger' are frequently rejected.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What's the difference between 26516, 26517, and 26518?

Digit count drives the code selection: 26516 for one digit, 26517 for two digits, 26518 for three or more. The digit count in the operative note must match exactly. Upcoding to 26518 when only two digits are documented is an audit risk.

02Can I bill 26517 with an MCP arthroplasty on the same hand?

Only if the capsulodesis is performed on a different digit than the arthroplasty and documented as a distinct procedure. NCCI bundling edits may apply; modifier 59 or XS is needed with clear documentation of the separate anatomic site and separate clinical indication.

03How do I bill this procedure when both hands are treated in the same session?

Append modifier 50 for bilateral, or use LT and RT on separate claim lines — whichever your payer requires. Medicare generally accepts modifier 50 on a single line; many commercial payers want separate lines. Confirm before submission to avoid rejections.

04Is modifier 22 ever appropriate with 26517?

Yes, if operative complexity is substantially above typical — for example, severe scarring from prior surgery, revision after failed prior capsulodesis, or unusual anatomic variation requiring significantly increased work. Document time, difficulty, and the reason for increased effort in the operative note. A cover letter with the claim strengthens the case.

05What global period applies, and what does it cover?

26517 carries a 90-day global. The day-before pre-op visit, the surgery, and all routine post-op care through day 90 are included. Splint or cast changes, suture removal, and routine wound checks are bundled. Unrelated problems need modifier 24 on the E/M; a same-day significant separate problem needs modifier 25.

06Which ICD-10 codes are typically paired with 26517?

Common pairings include MCP joint instability (M25.3- series with finger-specific laterality codes), volar plate laxity, and post-traumatic ligamentous laxity of the finger. Avoid non-specific 'disorder of finger' codes — they generate medical necessity denials at many payers.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the specific digits treated, the capsular structures incised and re-tensioned, the fixation technique, and intraoperative stability findings from the surgeon's dictation. That directly populates the operative note fields auditors check when distinguishing 26516, 26517, and 26518 — preventing downcoding denials caused by a generic 'two-digit capsulodesis' without anatomic detail.

See how Mira captures CPT 26517 documentation