Closed reduction of a single metacarpophalangeal joint dislocation by manual manipulation, performed without anesthesia.

Verified May 8, 2026 · 7 sources ↓

Medicare: $406.82
Total RVUs: 12.18
Global, days: 90
Region: Hand

Drawn from CMSAAOSAbosCgsmedicareNovitas

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Identify the specific digit and MCP joint involved (e.g., index finger MCP, left hand)
Confirm procedure performed without anesthesia — anesthesia use shifts the code to 26705
Document pre- and post-reduction neurovascular status of the affected digit
Record the mechanism of injury and imaging findings confirming dislocation and successful reduction
Note any associated fracture, ligament instability, or soft tissue injury that may affect coding or require separate reporting
Document the reduction technique and number of attempts required

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 7 cited references ↓

CPT 26700 covers closed treatment of a single metacarpophalangeal (MCP) joint dislocation with manipulation, performed without anesthesia. The treating provider physically maneuvers the displaced joint back into anatomic alignment — no incision, no general anesthesia. If anesthesia is required to achieve reduction, step up to 26705 instead.

The 90-day global period covers all routine post-reduction care through day 90: follow-up visits, splint checks, and dressing changes. Any E/M visit during that window unrelated to the MCP dislocation needs modifier 24. A same-day E/M for a significant, separately identifiable service needs modifier 25.

For bilateral MCP dislocations reduced in the same session, apply modifiers LT and RT on separate claim lines. Use modifier 79 if an unrelated surgical procedure is required during the 90-day global, and modifier 78 for an unplanned return to treat a related complication — not the other way around.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.73
Practice expense RVU	7.62
Malpractice RVU	0.83
Total RVU	12.18
Medicare national rate	$406.82
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	$406.82
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI P2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 26700 get rejected.

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

Wrong code selected when anesthesia was administered — should be 26705, not 26700
Missing laterality documentation when LT/RT modifiers are applied
E/M billed same-day without modifier 25 for a significant, separately identifiable service
Routine post-reduction follow-up billed separately within the 90-day global period without modifier 24
Insufficient imaging documentation to support dislocation diagnosis prior to reduction

Frequently asked questions

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

01When should I use 26705 instead of 26700?

Use 26705 when anesthesia — local, regional, or general — is required to achieve the reduction. If you document that reduction was performed without anesthesia, 26700 is correct. Payers will deny 26700 and may flag for audit if the anesthesia record contradicts the surgical claim.

02Can I bill an E/M visit on the same day as 26700?

Only if the E/M is significant and separately identifiable from the decision to reduce the dislocation. Append modifier 25 to the E/M. The E/M and the procedure don't need different diagnoses under NCCI policy, but the note must clearly support a distinct service beyond the reduction itself.

03How do I bill bilateral MCP dislocations reduced on the same date?

For facility (ASC/HOPD) claims, report two lines with modifier LT on one and RT on the other. For physician claims, bilateral reporting rules vary by payer — confirm whether your MAC accepts modifier 50 on a single line or requires separate LT/RT lines.

04What happens if the MCP re-dislocates and requires a second reduction during the 90-day global?

A repeat closed reduction by the same provider during the global period requires modifier 76. If performed by a different provider, use modifier 77. Neither resets the global period clock.

05Does an associated avulsion fracture change the code?

A minor avulsion at the MCP doesn't automatically require a separate fracture code, but document it in the operative note. If a distinct fracture requires separate manipulation or fixation, evaluate whether an additional code with modifier 59 or XS is supported. NCCI edits govern what can be unbundled — verify with the CGS NCCI PTP lookup before billing.

06If open reduction is ultimately required after a failed closed attempt, how do I code the date of the closed attempt?

Bill 26700 for the closed attempt on that date of service. If you proceed to open reduction (26705 requires anesthesia — open treatment has its own codes) on a different date, that's a new claim. If you convert to open in the same operative session, report only the open procedure code.

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 digit and joint name, laterality, confirmation that no anesthesia was used, pre- and post-reduction neurovascular exam, mechanism of injury, and imaging findings. That locks in the 26700 vs. 26705 distinction up front — the single most common coding error on this procedure — and prevents payer downcoding or outright denial for missing anesthesia documentation.

See how Mira captures CPT 26700 documentation