Closed treatment of an articular fracture at a metacarpophalangeal or interphalangeal joint, without manipulation, reported per finger.

Verified May 8, 2026 · 5 sources ↓

Medicare: $262.20
Work RVU: 2.02
Global, days: 90
Region: Hand

Drawn from AAPCKzanowCMS

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 joint involved: MCP, PIP, or DIP — not just 'finger fracture'
Confirm the fracture is articular (involves the joint surface) to distinguish from shaft fractures billed under 26720
Document why manipulation was not performed — acceptable alignment, non-displaced, or clinical judgment
Record the finger and laterality (e.g., right index finger, PIP joint) to support the appropriate finger modifier (FA, F1–F9)
Note the immobilization method applied (splint, cast, buddy tape) and that follow-up care is assumed by this provider
Include imaging findings (X-ray) confirming articular involvement and fracture displacement status

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 59 Distinct service LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

26740 covers closed (non-surgical) management of a fracture that involves the joint surface — either at the MCP or any IP joint of the finger — where no manipulation of the fracture fragments is performed. The fracture is stabilized through immobilization (splint, buddy taping, or cast), and the joint surface is not reduced because the fragment position is acceptable. This distinguishes 26740 from 26742, which applies when manipulation is required to achieve acceptable alignment.

26740 carries a 90-day global period. Casting, splinting, and strapping are bundled into the code — do not report a separate splinting code alongside it. If the treating provider assumes follow-up care, the global package applies from day one. The code descriptor says 'each,' meaning CPT rules allow one unit per injured finger with the appropriate finger modifier (FA, F1–F9). Under NCCI rules, however, if a single cast or splint treats multiple finger fractures without manipulation, only one unit of 26740 may be reported total — payer contract language determines which rule applies.

Select 26740 only when the fracture involves the articular surface at the MCP or IP joint. Non-articular phalangeal shaft fractures without manipulation belong under 26720 or 26750 (distal phalanx). If the joint surface fracture requires open reduction, use 26746. Document the specific joint involved (MCP, PIP, or DIP), the finger, laterality, and the clinical rationale for non-manipulative treatment.

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 (2.02) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (7.85) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	2.02
Practice expense RVU	5.44
Malpractice RVU	0.39
Total RVU	7.85
Medicare national rate	$262.20
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	$262.20
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 26740 get rejected.

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

Casting or splinting billed separately — both are bundled into 26740 and will be denied by NCCI edits
Wrong code selected: shaft fractures (26720) or distal phalanx fractures (26750) are not articular and don't map to 26740
Multiple units billed without finger modifiers, or multiple units billed for fingers treated under a single cast (NCCI limits to one unit in that scenario)
Missing or mismatched ICD-10 — audit teams flag claims where the diagnosis doesn't specify articular involvement or initial vs. subsequent encounter
Same-day E&M billed without modifier 25 when a significant, separately identifiable service was provided at the same visit

Frequently asked questions

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

01How does 26740 differ from 26720 and 26742?

26720 covers non-articular phalangeal shaft fractures without manipulation. 26740 is specifically for articular fractures (joint surface involved) without manipulation. 26742 is used when that same articular fracture requires manipulation to achieve acceptable alignment. Joint involvement is the key differentiator between 26720 and 26740.

02Can I bill a separate splinting code alongside 26740?

No. Casting, splinting, and strapping are included in 26740 per NCCI policy. Billing a separate splint code alongside a fracture treatment code will be denied. The same rule applies whether the provider assumes follow-up care or not.

03If I treat four fingers with one cast, how many units of 26740 can I bill?

Under CPT rules, the 'each' descriptor allows one unit per finger with the appropriate finger modifier. Under Medicare NCCI rules, only one unit may be reported when a single cast or splint treats multiple fractures without manipulation. For non-Medicare payers, check whether the contract explicitly adopts NCCI guidelines — that determines whether you can bill per finger or only once.

04What finger modifiers should I use with 26740?

Use FA for the left thumb, F1–F5 for the remaining left-hand fingers, F6 for the right thumb, and F7–F9 for the right index through little fingers. NCCI policy manual explicitly instructs that finger procedures be reported with these modifiers. This also helps when the same code is billed for multiple fingers on the same date.

05Can I bill an E&M on the same day as 26740?

Yes, if the E&M is significant and separately identifiable beyond the decision to perform the fracture treatment. Append modifier 25 to the E&M. Do not bill a decision-for-surgery E&M (modifier 57) with 26740 — modifier 57 applies to major surgical procedures with a 90-day global, but only when the decision visit occurs the day before or same day as the surgery. 26740 is a minor procedure with a 90-day global, and the pre-op E&M is bundled.

06Is the 90-day global for 26740 the same as for an open reduction?

Yes, 26740 carries a 090 global period — the same global length as open fracture repairs. That means all routine post-op visits, dressing checks, and cast changes through day 90 are bundled. Unrelated services during the global require modifier 24 on the E&M or modifier 79 on a new procedure.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the joint level (MCP, PIP, or DIP), the specific finger and laterality, the fracture displacement status from imaging, and the clinical rationale for non-manipulative treatment — all from dictation. That documentation directly supports the finger modifier selection and the articular fracture diagnosis required to defend 26740 against downcoding to 26720 on audit.

See how Mira captures CPT 26740 documentation