Closed reduction of a single interphalangeal joint dislocation in the finger, performed with manipulation and requiring anesthesia.
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $439.22
- Total RVUs
- 13.15
- Global, days
- 90
- Region
- Hand
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 6 cited references ↓
- Identify the specific finger and joint treated (e.g., right ring finger PIP joint) — not just 'finger dislocation'.
- Document the type and administration of anesthesia used; this is the primary distinction between 26775 and 26770.
- Record pre- and post-reduction imaging confirming the dislocation and confirming joint congruity after manipulation.
- Note the manipulation technique, number of reduction attempts, and whether closed reduction was successful.
- Document neurovascular status of the affected digit before and after reduction.
- Record post-reduction immobilization plan (splint type, position, duration).
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 6 cited references ↓
CPT 26775 describes closed (non-surgical) reduction of a dislocated interphalangeal joint — PIP or DIP — in a single finger, where manipulation is required and anesthesia is necessary to achieve reduction. The anesthesia requirement is what separates this code from 26770, which covers the same reduction without anesthesia. A digital block performed by the treating physician in the office generally supports 26770; 26775 is appropriate when the procedure is performed in an OR or ASC setting, or when documented anesthesia beyond a simple local infiltration is required and provided.
The code carries a 90-day global period. All routine follow-up care, splinting checks, and dressing changes within that window are bundled. If an unrelated E/M service is billed during the global, append modifier 24. If a separate, significant E/M occurs on the day of surgery for a distinct problem, append modifier 25 to that E/M. Staged or planned subsequent procedures within the global require modifier 58; unplanned returns for a related complication require modifier 78.
Laterality modifiers (LT/RT) are expected by most payers when a single finger is treated. Document the specific finger and joint (e.g., right long finger PIP joint) in both the operative note and on the claim. Missing laterality is a common clean-claim failure for this code.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 3.8 |
| Practice expense RVU | 8.59 |
| Malpractice RVU | 0.76 |
| Total RVU | 13.15 |
| Medicare national rate | $439.22 |
| 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 | $439.22 |
HOPD (APC 5102) Hospital outpatient department | $285.75 |
ASC (PI P2) Ambulatory surgical center (freestanding) | $153.62 |
Common denial reasons
The recurring reasons claims for CPT 26775 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Missing laterality modifier (LT or RT) — most payers require it for single-digit procedures.
- Upcoding from 26770 when the anesthesia documented is only a physician-administered digital block in the office, which typically supports 26770 instead.
- Global period conflicts — follow-up visits billed without modifier 24 within the 90-day global are automatically bundled and denied.
- Diagnosis code mismatch — ICD-10 must specify the finger, joint, and laterality to align with the procedure code.
- Lack of post-reduction imaging documentation to support medical necessity of the reduction procedure.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01What's the difference between 26770 and 26775?
02Can I bill 26775 when the physician does the digital block themselves in the office?
03Do I need a laterality modifier for 26775?
04What ICD-10 codes pair with 26775?
05How does the 90-day global period affect same-day E/M billing?
06When would modifier 22 apply to 26775?
07Can 26775 be billed bilaterally on the same date?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02aapc.comhttps://www.aapc.com/codes/cpt-codes/26775
- 03findacode.comhttps://www.findacode.com/cpt/26775-cpt-code.html
- 04fastrvu.comhttps://fastrvu.com/cpt/26775
- 05vsac.nlm.nih.govhttps://vsac.nlm.nih.gov/context/cs/codesystem/CPT/version/2019/code/26775/info
- 06aaos.orghttps://www.aaos.org/globalassets/quality-and-practice-resources/coding-and-reimbursement/resident-guide/resident-guide_modifiers.pdf
Mira AI Scribe
Mira's AI scribe captures the specific finger and joint dislocated, the anesthesia type and who administered it, the reduction technique, number of attempts, and post-reduction neurovascular and imaging findings — all from dictation. That detail directly supports the 26775 vs. 26770 distinction and prevents downcoding on audit when a payer questions whether anesthesia was truly required.
See how Mira captures CPT 26775 documentation