Fracture care · Hand

26720

Closed treatment of a proximal or middle phalangeal shaft fracture of a finger or thumb, performed without manipulation — billed per finger treated.

Verified May 8, 2026 · 5 sources ↓

Medicare
$235.48
Total RVUs
7.05
Global, days
90
Region
Hand
Drawn from KzanowAAPCCgsmedicareCMSEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Identify the specific finger(s) affected and the phalanx level (proximal or middle) for each fracture
  • Imaging report or direct reference confirming the fracture and confirming no displacement requiring manipulation
  • Type of immobilization applied (splint, buddy tape, short arm cast) and the specific finger(s) immobilized
  • Confirmation that no closed or open reduction was performed — distinguishes 26720 from 26725 or 26727
  • For multi-finger fractures: document each digit individually to support per-finger billing under CPT rules or to justify modifier 59 if needed
  • Post-reduction plan, weight-bearing or activity restrictions, and follow-up interval documented in the encounter note

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 5 cited references ↓

CPT 26720 covers non-manipulative closed treatment of a shaft fracture involving the proximal or middle phalanx of any finger or thumb. No reduction is performed — the fracture is managed with immobilization such as a splint, buddy taping, or cast. The 'each' language in the descriptor is operationally significant: under CPT rules, you can bill 26720 for each finger fractured, appending the appropriate digit modifier. Under NCCI rules (and payer contracts that adopt them), if a single cast or splint treats multiple closed fractures without manipulation, only one unit of 26720 is reportable regardless of finger count.

The 90-day global period bundles the initial cast or splint application — do not separately bill 29130 (static finger splint) or 29131 (dynamic finger splint) on the same date. That bundle applies from day one and is explicitly reinforced by NCCI. Any E/M on the same day requires modifier 25 if a separately identifiable service was provided before the fracture treatment decision.

For multi-finger fractures in non-Medicare patients, append F-series digit modifiers (F1–F9) to distinguish each finger when billing multiple units. For Medicare beneficiaries, apply NCCI's single-unit rule unless your documentation supports distinct anatomical sites that clearly justify modifier 59 — and even then, payer acceptance varies. Confirm the patient's coverage before determining your unit count.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU1.72
Practice expense RVU4.97
Malpractice RVU0.36
Total RVU7.05
Medicare national rate$235.48
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$235.48
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 26720 get rejected.

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

  • Billing 26720 with 29130 or 29131 on the same date — splint application is bundled into fracture care and will deny
  • Reporting multiple units of 26720 for a Medicare patient when a single cast treated all fractures — NCCI limits to one unit
  • Missing digit-level specificity in the operative or encounter note — auditors flag notes that say 'finger fracture' without identifying which phalanx and which digit
  • Unbundling an E/M on the same date without modifier 25 when the E/M was the visit that led directly to the fracture treatment
  • Using 26720 when the record documents manipulation or reduction — that maps to 26725 (with or without fixation) or 26727 (percutaneous fixation)

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can I bill 26720 four times if four fingers were fractured and treated with one cast?
Under CPT rules, yes — the 'each' descriptor permits one unit per finger, with digit modifiers. Under NCCI rules (mandatory for Medicare, adopted by many commercial payers), a single cast treating multiple closed fractures without manipulation limits you to one unit. Check whether the patient's payer contract adopts NCCI before billing multiple units.
02Is the splint or cast included in 26720, or can I bill it separately?
The initial splint or cast application is bundled into 26720. Billing 29130 or 29131 on the same date as 26720 violates NCCI and will deny. Subsequent cast changes during the 90-day global are also bundled unless a distinct separate service applies.
03What modifier do I use if I provide a separately identifiable E/M on the same day I treat the fracture?
Append modifier 25 to the E/M code to indicate it was a significant, separately identifiable service beyond the fracture treatment decision. Document what clinical work justified the separate E/M — a note that just describes the fracture won't support modifier 25.
04What is the difference between 26720 and 26725?
26720 is for closed treatment without manipulation — the fracture is non-displaced or acceptably aligned and requires only immobilization. 26725 is for closed treatment with or without manipulation, used when the physician actively reduces the fracture. The operative note must document which was performed; using 26720 when reduction occurred is undercoding and creates audit exposure.
05Does the 90-day global period affect billing for follow-up visits?
Yes. The 90-day global bundles all routine post-fracture follow-up visits, dressing changes, cast checks, and splint adjustments through day 90. An E/M during that window requires modifier 24 if it is for an unrelated condition, or modifier 79 for an unrelated procedure. Complications that require a return to the OR use modifier 78 (related) or 79 (unrelated).
06Which digit modifiers should I use when billing 26720 for multiple fingers on non-Medicare patients?
Use the F-series HCPCS digit modifiers: F1 through F4 for the left hand digits (index through little finger) and F5 through F9 for the right hand (thumb through little finger). Appending these to each unit of 26720 provides the anatomical specificity that supports multi-unit billing and reduces audit risk.

Mira AI Scribe

Mira's AI scribe captures the specific digit and phalanx level (proximal vs. middle), the fracture displacement status, the immobilization method applied, and the explicit statement that no manipulation was performed — all from dictation. That level of specificity prevents the two most common audit flags on 26720: missing phalanx identification and ambiguous documentation that could support upcoding to 26725.

See how Mira captures CPT 26720 documentation

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