Arthrodesis of the carpometacarpal joint of a finger (not the thumb), performed with autograft harvested from the patient's own body during the same operative session.
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $840.70
- Total RVUs
- 25.17
- 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 ↓
- Specify which digit's CMC joint was fused (index, long, ring, or small finger) — 'non-thumb CMC' alone is insufficient for audit purposes.
- Confirm autograft source in the operative note: donor site, amount harvested, and preparation method.
- Document internal fixation device type and placement if used (K-wire, plate, screw), or explicitly note that fixation was not employed.
- Record the patient's diagnosis by ICD-10 code — common drivers include CMC osteoarthritis (M18.x), post-traumatic arthritis, or joint instability following ligamentous injury.
- Note the surgical approach and confirm the joint was taken down to bleeding subchondral bone before graft placement.
- Document informed consent confirming the patient understood the graft harvest site and fusion goals.
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 26844 covers surgical fusion of a carpometacarpal (CMC) joint of any finger other than the thumb, where the surgeon also harvests and applies autogenous bone graft to stimulate joint consolidation. The graft harvest is bundled — do not separately report a graft procurement code. Internal fixation, when used, is also included in the procedure. Report this code once per fused CMC joint; when multiple non-thumb CMC joints are fused at the same session, append modifier 51 to the additional code(s) or use the appropriate additional units per payer instructions.
This code sits in a family with 26843, which covers the same CMC arthrodesis without autograft. If the surgeon planned the procedure with autograft from the outset, 26844 is correct. If an allograft or synthetic bone substitute is used instead of the patient's own bone, verify payer policy — 26844's descriptor specifically requires autograft.
The 90-day global period means all routine post-op care through day 90 is bundled. Fracture care, hardware removal, or treatment of unrelated conditions during that window require modifier 24 or 79, respectively. Same-day E/M services require modifier 25 on the office visit to survive NCCI scrutiny.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 8.76 |
| Practice expense RVU | 14.55 |
| Malpractice RVU | 1.86 |
| Total RVU | 25.17 |
| Medicare national rate | $840.70 |
| 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 | $840.70 |
HOPD (APC 5114) Hospital outpatient department | $7,413.38 |
ASC (PI J8) Ambulatory surgical center (freestanding) | $5,104.04 |
Common denial reasons
The recurring reasons claims for CPT 26844 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Autograft not documented in the operative note — payer downcodes to 26843 and recoups the difference.
- Multiple CMC joints fused same session billed without modifier 51, triggering a bundling edit.
- ICD-10 diagnosis code does not support arthrodesis (e.g., acute fracture coded without documenting failed conservative treatment or clinical necessity for fusion).
- Graft procurement separately billed in addition to 26844, which already includes obtaining the autograft.
- E/M service billed same day without modifier 25, bundled under the global payment rules.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01What is the difference between CPT 26843 and 26844?
02Can I bill for the graft harvest separately when reporting 26844?
03How do I bill if the surgeon fused two non-thumb CMC joints in the same hand at the same session?
04What modifier is required if the surgeon returns to the OR within the 90-day global to address hardware failure at the same site?
05Does the 90-day global period cover the donor site management for the autograft harvest?
06Which ICD-10 codes most commonly support 26844?
07Is 26844 payable in an ASC setting?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02bedrockbilling.comhttps://bedrockbilling.com/static/cci/26844
- 03cms.govhttps://www.cms.gov/medicare/coding-billing/ncci-medicaid/medicaid-ncci-policy-manual
- 04abos.orghttps://www.abos.org/wp-content/uploads/2019/12/hand-cpt-updated.pdf
- 05cms.govhttps://www.cms.gov/files/document/2026-medicaid-ncci-technical-guidance-manual-02282026.pdf
- 06findacode.comhttps://www.findacode.com/cpt/26844-cpt-code.html
Mira AI Scribe
Mira's AI scribe captures the specific digit fused, autograft donor site and harvest details, fixation method (or explicit absence of fixation), and approach used — the exact elements auditors check when distinguishing 26844 from 26843 and when reviewing for unbundled graft codes. Missing autograft documentation is the leading reason payers downcode this procedure on post-payment review.
See how Mira captures CPT 26844 documentation