Closed reduction of a single finger interphalangeal joint dislocation performed with manual manipulation, without anesthesia.

Verified May 8, 2026 · 5 sources ↓

Medicare: $361.73
Work RVU: 3.07
Global, days: 90
Region: Hand

Drawn from CMSAAPCAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify which finger and which joint (PIP or DIP) was dislocated and reduced
Document the direction of dislocation (dorsal, volar, lateral) and mechanism of injury
Record pre- and post-reduction neurovascular status of the digit
Note that reduction was performed by closed manipulation without anesthesia
Document post-reduction stability assessment and range of motion findings
Record any post-reduction imaging obtained and its findings confirming joint congruity

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 XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 26770 covers closed treatment of a single interphalangeal (IP) joint dislocation in the hand — either proximal (PIP) or distal (DIP) — performed with manipulation and without anesthesia. The treating provider manually reduces the dislocated joint and typically confirms reduction clinically or with post-reduction imaging. No surgical incision is involved.

The code carries a 90-day global period, which includes the reduction itself and all routine follow-up through day 90. Any E/M service on the same day as the reduction requires modifier 25 to be separately billable. If a decision for surgery (escalation to open reduction) is made during a same-day visit, append modifier 57 to that E/M. Post-reduction imaging is separately billable and not bundled into the global.

When multiple IP joints are reduced on different fingers during the same encounter, each additional joint is coded separately with modifier 59 or XS to establish distinct anatomical sites. Bilateral finger involvement on opposite hands uses modifiers LT and RT. If the dislocation proves irreducible by closed means and open surgery follows during the same encounter, 26770 is not separately reported — bill the open reduction code instead.

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 (3.07) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (10.83) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	3.07
Practice expense RVU	7.07
Malpractice RVU	0.69
Total RVU	10.83
Medicare national rate	$361.73
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	$361.73
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI G2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 26770 get rejected.

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

Missing laterality or finger designation — payer cannot determine which digit was treated
Billing 26770 alongside an open reduction code for the same joint on the same date
Unbundled E/M on the same date without modifier 25, triggering global period edit
ICD-10 diagnosis code does not specify dislocation (e.g., using sprain or strain codes instead of S63.2xx series)
Multiple units billed for the same code without modifier 59 or XS to distinguish separate IP joints

Frequently asked questions

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

01Can I bill 26770 more than once if I reduce two different fingers at the same visit?

Yes. Each IP joint on a separate finger is a distinct anatomical site. Report 26770 for each joint reduced and append modifier 59 or XS to the additional units to establish separate sites. Bill the primary reduction without a modifier and each additional with 59/XS.

02Does the 90-day global include post-reduction imaging?

No. Radiology codes (e.g., X-ray of finger) are not surgical services and are not bundled into the fracture/dislocation global period. Bill post-reduction imaging separately with the appropriate radiology CPT code.

03The dislocation was irreducible and I ended up doing an open reduction in the same session. Do I still bill 26770?

No. When closed reduction fails and open reduction is performed during the same encounter, report only the open reduction code. Billing both closed and open reduction for the same joint on the same date will trigger a bundling denial.

04What ICD-10 codes support 26770?

Use the S63.2xx series — dislocation of interphalangeal joint of finger. Payers expect a specificity-appropriate code that names the joint and laterality. Generic sprain or pain codes will mismatch and trigger denial.

05If I see the patient in the office, diagnose the dislocation, and reduce it the same day, can I bill the E/M separately?

Yes, but modifier 25 is required on the E/M. The E/M must be significant and separately identifiable from the pre-service work already included in 26770. Document the decision-making that preceded the reduction as a distinct clinical evaluation.

06Does 26770 require anesthesia to be reported separately?

No. The procedure is defined as reduction without anesthesia. If local or regional anesthesia is used, it is not separately reportable per NCCI policy — injections of local anesthesia for musculoskeletal manipulative procedures are bundled into the primary code.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the specific finger, joint level (PIP vs. DIP), dislocation direction, manipulation technique, pre- and post-reduction neurovascular exam, stability assessment, and whether post-reduction imaging was obtained — all from dictation. That level of joint-specific detail prevents laterality denials and satisfies audit requests for documentation supporting the 90-day global.

See how Mira captures CPT 26770 documentation