Osteotomy of a finger phalanx to correct angular or structural deformity, reported per finger.

Verified May 8, 2026 · 7 sources ↓

Medicare: $700.08
Work RVU: 6.82
Global, days: 90
Region: Hand

Drawn from CMSFastrvuEatonhandEmednyMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify which phalanx (proximal, middle, or distal) and which digit (index, long, ring, small, thumb) was operated on
Document the type and cause of the deformity — angular malalignment, malunion, delta phalanx, congenital clinodactyly, etc.
Describe the osteotomy technique: wedge, opening wedge, closing wedge, or corrective dome osteotomy
Record fixation method used — K-wire, mini-screw, plate — with planned removal or retention details
Note preoperative and intraoperative imaging confirming deformity correction
If multiple fingers operated in the same session, the operative note must individually document each phalanx corrected to support multiple units

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 59 Distinct service LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 26567 describes a phalangeal osteotomy performed to correct a bony deformity of the finger — most commonly angular malalignment (e.g., clinodactyly, malunion after fracture, or delta phalanx). The surgeon cuts and repositions the phalanx to restore anatomic alignment, typically securing the correction with pins or fixation hardware. The code is reported per finger; if the same deformity correction is performed on multiple fingers in the same session, each phalanx corrected gets its own unit.

This code carries a 90-day global period. That means the operative session, the day-before visit, and all routine follow-up through day 90 — including pin removal — are bundled. Anything outside routine post-op care in that window requires modifier 24 (E/M unrelated to surgery) or modifier 79 (unrelated procedure). A new problem presenting during the global period can still be billed, but documentation must be explicit that it is unrelated.

Side laterality matters for this code. Append LT or RT to identify the operative hand. If the procedure is performed bilaterally in the same session — deformity corrected on a finger of each hand — report once with modifier 50. Multiple fingers on the same hand in the same session are reported with separate line items and modifier 51 on the secondary procedure(s).

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 (6.82) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.96) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.82
Practice expense RVU	12.81
Malpractice RVU	1.33
Total RVU	20.96
Medicare national rate	$700.08
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	$700.08
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 26567 get rejected.

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

Missing digit-level specificity in the operative note — payer cannot confirm which phalanx was corrected
Units denied when multiple fingers billed without individual documentation of each correction in the op note
Bilateral modifier 50 denied when LT/RT not also documented in the record or claim
Routine pin removal during the 90-day global billed as a separate service without supporting documentation that it was unplanned
ICD-10 diagnosis code does not specify laterality or anatomic site, triggering a mismatch with LT/RT modifier on the claim

Frequently asked questions

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

01Is 26567 reported per finger or per hand?

Per finger. If you correct phalangeal deformities on three fingers in one session, report 26567 three times — primary line without modifier, then modifier 51 on each additional unit.

02Can I bill 26567 and 26565 together if I correct both a phalanx and a metacarpal on the same hand?

Yes. 26567 covers the phalanx osteotomy and 26565 covers the metacarpal osteotomy. These are distinct anatomic sites and separate procedure codes. Append modifier 51 to the lower-valued procedure and verify no NCCI PTP edit bundles the pair.

03What modifier do I use for a bilateral same-session procedure?

Report 26567 once with modifier 50 when the identical deformity correction is performed on the same digit of each hand in the same session. Document bilaterality explicitly in the operative report.

04Pin removal is scheduled at 4 weeks post-op — is that separately billable?

No. Planned pin removal within the 90-day global period is bundled. If the removal is complicated or unplanned due to a new problem (e.g., hardware migration requiring a return to the OR), modifier 78 applies for a related return procedure.

05Which ICD-10 codes typically pair with 26567?

Congenital finger deformities (Q68.1, Q74.0), acquired deformity of finger (M20.00–M20.09), and malunion of phalanx fracture (M84.34x-) are common pairings. Laterality must match the LT or RT modifier on the claim.

06Does 26567 differ from 26590 (repair macrodactylia)?

Yes. 26567 is an osteotomy specifically for angular or structural bony malalignment. 26590 addresses macrodactyly — abnormal size of a digit. Select based on the documented pathology, not interchangeably.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the operative dictation for 26567 in real time: digit name, phalanx level, deformity type, osteotomy technique, and fixation hardware. It flags notes that say only 'corrective osteotomy of finger' without specifying which digit or phalanx — the single most common audit trigger for this code. When multiple fingers are corrected, the scribe auto-prompts per-digit documentation to support each billed unit.

See how Mira captures CPT 26567 documentation