Fusion · Hand

26861

Add-on code for arthrodesis of each additional interphalangeal joint of the finger, performed with or without internal fixation, reported alongside the primary finger joint fusion code.

Verified May 8, 2026 · 4 sources ↓

Medicare
$86.84
Total RVUs
2.6
Global, days
Region
Hand
Drawn from CMSAAPCMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 4 cited references ↓

  • Identify each specific digit and joint level fused (e.g., right long finger DIP, left index PIP) — vague references to 'additional finger joint' will not support digit-specific modifiers.
  • State whether internal fixation was used and, if so, the hardware type (K-wire, headless compression screw, staple, etc.).
  • Operative note must reference the parent procedure (26860 or 26862) and explicitly describe the additional joint fusion as a separate surgical step.
  • Document the clinical indication for multi-joint fusion — degenerative arthritis, post-traumatic deformity, inflammatory arthritis — matched to ICD-10 diagnosis codes for each affected joint.
  • If autograft was harvested for any joint, differentiate which joints required graft (those joints bill 26863/26863 add-on series, not 26861).

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 4 cited references ↓

26861 is an add-on code billed for each additional interphalangeal (IP) joint fused during the same operative session as a primary finger arthrodesis. It cannot stand alone — 26860 (primary IP joint fusion without autograft) must appear on the same claim as the parent code. The surgeon immobilizes the additional IP joint through surgical fusion, with or without internal fixation hardware such as pins, screws, or staples.

Because 26861 carries a ZZZ global period, it inherits the global package of its parent procedure. Do not apply a separate global period calculation to this code. When three joints are fused across different fingers in the same session, report 26860 once for the first joint, then 26861 for each additional joint — digit-specific modifiers (F-series) are required to distinguish laterality and digit.

Do not append modifier 51 to 26861. Add-on codes are exempt from multiple procedure reduction; modifier 51 is incorrect here and will trigger a processing error with most payers. Verify NCCI edits when billing 26861 alongside other hand procedure codes to avoid bundling denials.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU1.7
Practice expense RVU0.56
Malpractice RVU0.34
Total RVU2.6
Medicare national rate$86.84
Global perioddays

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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$86.84

Common denial reasons

The recurring reasons claims for CPT 26861 get rejected.

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

  • Billing 26861 without the required parent code (26860) on the same claim — payers reject the add-on as unbundled or orphaned.
  • Appending modifier 51 to 26861, which flags it incorrectly as a multiple procedure subject to reduction; add-on codes are modifier-51 exempt.
  • Missing or mismatched digit-specific F-series modifiers when multiple joints across different fingers are fused, leading to MUE or bundling edits.
  • Upcoding 26861 to 26863 (autograft add-on) when no bone graft was harvested — auditors look for graft harvest documentation before allowing 26863.
  • ICD-10 diagnosis does not support multi-joint fusion — single-digit diagnosis paired with multiple joint fusion codes triggers medical necessity review.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01Do I need modifier 51 on 26861?
No. 26861 is an add-on code and is explicitly exempt from modifier 51. Appending it will cause a processing error or incorrect payment reduction with most payers.
02What is the parent code for 26861?
26860 is the standard parent (IP joint fusion without autograft). If autograft is used on the primary joint, 26862 is the parent. 26861 must appear on the same claim as the parent code or it will deny as an orphaned add-on.
03If I fuse three IP joints across three separate fingers in one session, how do I report that?
Report 26860 for the first joint with the appropriate digit modifier, then 26861 twice — once for each additional joint — each with its own digit-specific F-series modifier to distinguish the digits. Do not repeat 26860.
04What if autograft is used for the additional joint but not the primary joint?
That is an unusual clinical scenario, but if autograft was harvested for the additional joint, report 26863 as the add-on instead of 26861. Document graft harvest in the operative note — payers will audit for this.
05Does 26861 carry its own global period?
26861 has a ZZZ global period, meaning it has no independent global package. It rolls into the global period of the parent procedure (26860 or 26862), which carries a 90-day global.
06Which digit modifiers apply to 26861?
Use CMS F-series HCPCS modifiers (F1–F9, FA) to identify the specific digit. These are required when billing multiple 26861 units or when both hands are involved, so the payer can adjudicate each joint separately.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    aapc.com
    https://www.aapc.com/codes/cpt-codes/26861
  3. 03
    mdclarity.com
    https://www.mdclarity.com/cpt-code/26861
  4. 04
    cms.gov
    https://www.cms.gov/files/document/01-chapter1-ncci-medicare-policy-manual-2025finalcleanpdf.pdf

Mira AI Scribe

Mira's AI scribe captures the specific digit, joint level (DIP vs. PIP), internal fixation type and size, and whether bone graft was used for each additional joint fused. That detail populates the correct digit modifier (F-series), distinguishes 26861 from 26863, and prevents the two most common denials on multi-joint fusion claims: missing parent-code linkage and wrong add-on code selection.

See how Mira captures CPT 26861 documentation

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