Closed treatment of a distal phalanx fracture of a finger or thumb, without manipulation — meaning the bone is already in acceptable alignment and stabilized with a splint or cast rather than surgically repositioned.

Verified May 8, 2026 · 5 sources ↓

Medicare: $220.45
Total RVUs: 6.6
Global, days: 90
Region: Hand

Drawn from CMSAAOSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Radiographic confirmation of fracture at the distal phalanx level, with alignment findings documented
Specific digit identified by name and laterality (e.g., left index finger distal phalanx)
Explicit statement that no manipulation was performed and rationale (non-displaced, acceptable alignment)
Type and application of immobilization device (e.g., stack splint, dorsal aluminum splint)
Plan for follow-up and expected course of closed treatment within the 90-day global

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 26750 covers closed (non-surgical) treatment of a distal phalangeal fracture of any finger or thumb when the fracture is non-displaced and requires no manipulation. The treating provider reviews imaging to confirm alignment, then applies a protective splint or cast. The word 'each' in the descriptor is operative: bill one unit per finger treated, and use digit-specific modifiers (FA, F1–F9) to distinguish which finger was treated on that date.

The 90-day global period bundles the application visit, routine follow-up imaging review, cast or splint changes, and removal through post-op day 90. If the patient returns within that window with an unrelated complaint, bill the E/M with modifier 24. If you're making the surgical decision on the same day as an E/M, append modifier 57 to that E/M. If the fracture later requires manipulation or fixation — escalating to 26755, 26756, or an open procedure — use modifier 58 on the subsequent code and document the staged-procedure intent in the initial note.

Don't confuse 26750 with 26720 (proximal or middle phalangeal shaft, without manipulation) or 26740 (articular fracture at MCP or IP joint, without manipulation). Payer auditors flag undifferentiated operative notes that omit the specific phalanx level. Per NCCI policy, casting and splinting codes are bundled into 26750 when you assume follow-up care — don't separately report strapping codes in that scenario.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	1.76
Practice expense RVU	4.47
Malpractice RVU	0.37
Total RVU	6.6
Medicare national rate	$220.45
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	$220.45
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 26750 get rejected.

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

Missing digit-specific modifier (FA, F1–F9) when MUE of 1 per line triggers a units edit
Separate billing of splint application code on the same date when provider assumes follow-up care — bundled by NCCI
Upcoding to 26755 (with manipulation) without documentation of displacement and reduction attempt
E/M billed same-day during global period without modifier 24 or 25, triggering global period denial
Operative or clinic note states only 'finger fracture treated' without specifying distal phalanx level, prompting medical necessity review

Frequently asked questions

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

01Can I bill 26750 twice if I treat two fingers on the same hand the same day?

Yes. The descriptor includes 'each,' so bill one unit per finger treated. Append digit-specific modifiers (FA, F1–F9) to each line so payers can distinguish them. The MUE of 1 per line is designed around these modifiers — without them, the second unit will deny.

02The fracture turns out to be displaced and I manipulate it at the same visit — do I still use 26750?

No. If you perform manipulation, the correct code is 26755 (distal phalanx, with manipulation). Document the displacement on imaging and the reduction technique. Billing 26750 when manipulation occurred is a misrepresentation of the service.

03Can I separately bill the splint application when treating the fracture?

Not when you're assuming follow-up care. Per NCCI policy, the splint or cast application is bundled into the fracture treatment code. You may only separately report a strapping code if you apply the immobilization as the sole initial service and will not be providing definitive treatment or follow-up.

04The patient comes back on day 45 with shoulder pain unrelated to the finger. How do I bill the E/M?

Append modifier 24 to the E/M code. That signals to the payer the visit is unrelated to the fracture and falls outside what the global period covers. Document clearly that the presenting complaint is distinct from the finger injury.

05When should I use modifier 58 versus 78 for a return procedure during the global period?

Use modifier 58 if the follow-up procedure was planned or staged from the outset (e.g., you always intended to progress to pinning). Use modifier 78 if the patient returns to the OR for an unplanned procedure directly related to the original fracture care, such as a complication. Never invert these — modifier 78 is for unplanned related returns; modifier 58 is for staged or anticipated next steps.

06Does modifier 50 apply if I treat the same distal phalanx fracture bilaterally?

Modifier 50 is for bilateral procedures on paired anatomic sites. If truly the same finger on both hands is fractured and treated the same day, modifier 50 can apply per CMS bilateral billing rules. More commonly, different digits are involved — in that case, use digit-specific modifiers on separate lines rather than modifier 50.

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 specific digit name and laterality, the phalanx level (distal), the imaging findings confirming non-displacement, and the immobilization method applied — all from dictation. That prevents the most common audit flag for 26750: an operative note that identifies only 'finger fracture' without confirming the distal phalanx location and the absence of manipulation.

See how Mira captures CPT 26750 documentation