Open surgical treatment of a single metacarpophalangeal (MCP) joint dislocation, with internal or external fixation used when required to maintain reduction.

Verified May 8, 2026 · 7 sources ↓

Medicare: $545.10
Work RVU: 6.85
Global, days: 90
Region: Hand

Drawn from CMSAAPCAbosBedrockbillingFindacode

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 finger and side (e.g., right index finger MCP joint) in the operative note header and body.
Document why open treatment was necessary — failed closed reduction, volar plate interposition, or other soft-tissue obstruction blocking reduction.
Name the fixation method used (K-wire, external pin, screw) or explicitly state fixation was not required.
Record the pre- and post-reduction neurovascular status of the digit.
Include intraoperative fluoroscopy or imaging findings confirming reduction, if obtained.
Specify the surgical approach used (e.g., dorsal, volar/palmar) — operative notes that only say 'standard approach' are audit flags.

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 26715 covers open reduction of a single MCP joint dislocation — the joint at the base of a finger where the metacarpal meets the proximal phalanx. The open approach is chosen when closed or percutaneous methods have failed or when soft-tissue interposition (commonly the volar plate or a tendon) blocks reduction. The surgeon opens the joint, clears the obstruction, reduces the dislocation, and may stabilize the joint with pins, wires, or screws as the anatomy dictates.

This code carries a 90-day global period. All routine post-op visits, dressing changes, pin-track care, and splint adjustments through day 90 are bundled. An unrelated E/M during the global window requires modifier 24; a separate, distinct procedure requires modifier 79. If ligament repair (e.g., 26540) is performed at the same encounter, document it as a distinctly separate service — NCCI bundling logic applies and modifier 59 or XS may be needed to support separate payment.

Code 26715 is used once per dislocated MCP joint. If multiple MCP joints are treated at the same session, each additional joint should be reported with modifier 59 to reflect the distinct anatomic sites. Laterality modifiers (LT/RT) identify which hand; modifier 50 is not applicable here since bilateral simultaneous MCP dislocations requiring open treatment are clinically rare.

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 (6.85) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.32) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.85
Practice expense RVU	8.15
Malpractice RVU	1.32
Total RVU	16.32
Medicare national rate	$545.10
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	$545.10
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 26715 get rejected.

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

Missing documentation of why open treatment was medically necessary over closed or percutaneous methods.
ICD-10 diagnosis code does not specify laterality or the affected digit, creating a CPT-ICD mismatch.
Ligament repair (26540) billed same-day without modifier 59 or XS triggers NCCI bundling denial.
Post-op E/M visit billed during the 90-day global period without modifier 24 or 25.
Operative note lacks documentation of fixation decision — payers may question whether a higher or lower-complexity code applies.

Frequently asked questions

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

01What distinguishes 26715 from 26706?

26706 is percutaneous skeletal fixation with manipulation — a closed technique using pins without formal joint opening. 26715 requires a surgical incision to directly visualize and reduce the joint. If the operative note documents an open approach, 26715 is correct.

02Can I bill 26715 for two fingers on the same hand in one session?

Yes. Report 26715 for the primary digit, then 26715 again with modifier 59 and the appropriate laterality modifier for each additional MCP joint treated at the same session. Document each digit separately in the operative note.

03If I repair the collateral ligament at the same time, can I also bill 26540?

Only if the ligament repair is documented as a distinct procedure beyond what is inherent to the open reduction. NCCI bundles 26540 with 26715 by default. Use modifier 59 or XS and ensure the operative note separately describes the ligament injury and repair steps.

04Does the 90-day global period apply here?

Yes. The global period is 90 days. Routine follow-up visits, splint management, and pin removal within that window are bundled. To bill an unrelated E/M during the global, append modifier 24. A decision-for-surgery visit the day before requires modifier 57.

05Is 26715 appropriate when the dislocation is associated with a fracture at the same joint?

If the primary pathology treated is the dislocation and fixation addresses both, 26715 may still apply. However, if a separate fracture required independent fixation, review whether a fracture repair code better represents the work performed. Document each component of the injury and treatment distinctly.

06What ICD-10 codes typically map to 26715?

S63.2xx series codes cover MCP joint dislocations. Code to the highest specificity — include laterality (right vs. left) and the specific digit (index, middle, ring, little finger). Unspecified digit codes increase denial risk on claims.

Sources & references

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

Mira Scribe

The Mira AI Scribe captures the specific finger, laterality, reason open treatment was chosen over closed reduction, the type of obstruction encountered intraoperatively, the fixation method selected or explicitly declined, and the post-reduction stability assessment. This prevents the two most common denials for 26715: missing medical necessity justification for the open approach and unspecified digit or side creating an ICD-10 mismatch on the claim.

See how Mira captures CPT 26715 documentation