Surgical release of a finger joint contracture via incision or excision of the interphalangeal joint capsule, performed on a single joint.

Verified May 8, 2026 · 7 sources ↓

Medicare: $677.04
Work RVU: 5.36
Global, days: 90
Region: Hand

Drawn from CMSFastrvuFindacodeNimblercmAAPC

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify the exact joint(s) treated — PIP, DIP, or MCP — and identify the digit and laterality (e.g., left ring PIP joint)
Document pre-operative range of motion deficit with measured extension lag or flexion contracture in degrees
Describe the surgical technique: whether capsulotomy (incision only) or capsulectomy (excision) was performed and the extent of tissue removed
State the medical necessity: failed conservative treatment, duration of contracture, and functional impairment documented in the history
If tenolysis was performed at the same session, document that the tendon release and joint capsule release were each distinct and necessary components
Record intraoperative passive range of motion achieved after release to substantiate the procedure's completeness

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 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 7 cited references ↓

CPT 26525 covers surgical release of a contracture at an interphalangeal (IP) joint of the finger — either through incision into or excision of the joint capsule between two phalanges. The goal is to restore passive and active extension range of motion lost to joint capsule tightening, scarring, or fibrosis. The code is reported per joint; multiple contracted joints on the same operative day each get their own unit with modifier 51 appended to the secondary units.

The code sits in a 90-day global period, so all routine postoperative care — wound checks, splint adjustments, and supervised hand therapy visits for the released joint — is bundled. Unrelated procedures or E/M visits during the global require modifier 24 or 79 to bypass the global bundle. When performed alongside a tenolysis (e.g., 26440 for flexor tendon), per AMA CPT Assistant (March 2003), report both codes: the tenolysis as primary and 26525-51 for the capsulotomy component.

26525 is anatomically distinct from Dupuytren contracture codes (26121, 26123, 26125), which address palmar fascia pathology. Audit teams flag cases where palmar fascia excision and 26525 are billed together without clear documentation that the joint capsule work was separate and necessary beyond the fascial release.

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 (5.36) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.27) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.36
Practice expense RVU	13.87
Malpractice RVU	1.04
Total RVU	20.27
Medicare national rate	$677.04
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	$677.04
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 26525 get rejected.

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

Bundling denial when 26525 is billed alongside Dupuytren fasciotomy or fasciectomy codes without documentation that joint capsule work was separate from the fascial release
Missing laterality — no modifier LT or RT appended, triggering claim edit or return
Insufficient medical necessity documentation: no pre-op range-of-motion measurements or no record of failed conservative management
Multiple units denied because each joint was not individually identified in the operative note; payer cannot confirm separate capsule release at each reported joint
Global period conflict when a follow-up E/M is billed during the 90-day window without modifier 24, causing automatic denial as a bundled service

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Is 26525 reported per finger or per joint?

Per joint. If you release the PIP and DIP on the same finger in the same session, report 26525 twice — once as primary, once with modifier 51. Document each joint release separately in the operative note.

02How does 26525 differ from the Dupuytren codes 26121/26123/26125?

26525 addresses joint capsule pathology at the interphalangeal level. Dupuytren codes address palmar fascia cord excision or incision. If the surgeon excises the cord through the palm and into the finger and releases the PIP joint as part of that dissection, use 26123 — not 26525. Reserve 26525 for contractures where the capsule itself is the primary target.

03Can 26525 and a tenolysis code be billed together on the same day?

Yes. Per AMA CPT Assistant (March 2003), when a flexor tenolysis (e.g., 26440) and an IP joint capsulotomy are both performed and documented as distinct steps, report both — tenolysis as primary and 26525-51 for the capsulotomy. The operative note must describe each release as a separate, necessary component.

04What modifiers are needed when operating on multiple fingers bilaterally?

Use LT and RT to identify laterality for each claim line. For multiple joints on the same hand in the same session, append modifier 51 to the secondary and subsequent units of 26525. Modifier 50 applies if truly mirror-image bilateral procedures are performed on the same joint of both hands.

05What is the global period for 26525, and what does it include?

26525 carries a 90-day global period. All routine postoperative visits, wound care, splinting adjustments, and hand therapy supervision related to the released joint are bundled through day 90. Bill unrelated E/M services during that window with modifier 24; unrelated surgical procedures need modifier 79.

06If the contracture recurs and the same joint needs re-release within 90 days of the original surgery, which modifier applies?

If the return to the OR is for the original contracture (a related complication or incomplete release), use modifier 78. If a new, unrelated procedure is performed during the global period, use modifier 79. Do not use these interchangeably — payers audit the distinction.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the specific joint name and digit (e.g., 'left ring finger PIP joint capsulectomy'), the surgical technique (capsulotomy vs. capsulectomy), pre- and post-release range of motion, and whether a concurrent tenolysis was performed as a distinct step. This prevents the two most common audit flags: an operative note that reads 'finger contracture release' without joint-level specificity, and bundling disputes when tenolysis is billed alongside without documented separation of the two procedures.

See how Mira captures CPT 26525 documentation