Surgical amputation of a single finger or thumb at any joint or phalanx level, performed as a primary or secondary procedure, including neurectomies, with direct closure of the wound.

Verified May 8, 2026 · 6 sources ↓

Medicare: $699.41
Work RVU: 5.89
Global, days: 90
Region: Hand

Drawn from CMSAAPCFindacodeBedrockbillingEatonhand

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) were amputated using finger/thumb identification (e.g., right small finger, left ring finger).
Document the level of amputation: joint (MCP, PIP, DIP) or specific phalanx (proximal, middle, distal).
Confirm whether the procedure is primary or secondary (revision), as this affects diagnosis coding and medical necessity.
Document that neurectomy was performed and direct closure was achieved — open wound management is not included here.
Record indication for amputation: trauma, infection, malignancy, ischemia, or other diagnosis driving medical necessity.
Note laterality and hand (right or left) explicitly in the operative note — audit teams flag notes that lack this detail.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 58 Staged or related 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

26951 covers amputation of a single finger or thumb — at any joint or phalanx level — with direct closure and concurrent neurectomy. It applies whether the procedure is primary (initial trauma or disease) or secondary (revision of a previous amputation). Each amputated digit is a separate reportable unit; the MUE is 8, reflecting the anatomical maximum.

The 90-day global period means all routine post-op wound care, suture removal, and follow-up visits are bundled through day 90. Anything unrelated to the amputation billed inside that window needs modifier 24 or 79. A planned staged procedure within the global uses modifier 58; an unplanned return for a related complication uses modifier 78.

When multiple digits are amputated in the same session, do not stack units or apply modifier 50. Instead, report 26951 twice with individual digit modifiers (F-series: F1–F9, FA) to distinguish each digit. Modifier 59 or XS alone will not resolve MUE conflicts here — finger-level modifiers are the correct vehicle.

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 (5.89) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.94) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.89
Practice expense RVU	13.88
Malpractice RVU	1.17
Total RVU	20.94
Medicare national rate	$699.41
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	$699.41
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 26951 get rejected.

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

Billing multiple units of 26951 without individual digit (F-series) modifiers — claims scrubbers reject stacked units on this code.
Missing or mismatched laterality: operative note says right hand but claim lacks RT or F-series modifier.
Post-op visit billed without modifier 24 inside the 90-day global, resulting in automatic bundling denial.
Using modifier 50 (bilateral) for digits on opposite hands — 26951 is a single-digit code; each digit needs its own line with a digit-specific modifier.
Diagnosis code does not support the level or urgency of amputation (e.g., a non-ischemic, non-traumatic diagnosis paired without supporting documentation).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can I bill 26951 twice when two fingers are amputated in the same session?

Yes. Report 26951 on two separate lines, each with a unique F-series digit modifier (e.g., F3 for left ring finger, F9 for right small finger). Do not stack units or use modifier 50 — 26951 is not a bilateral procedure code.

02What modifier applies when the patient returns to the OR within the global for a wound complication?

Use modifier 78 for an unplanned return to the OR for a complication related to the original amputation. Modifier 79 is for an unrelated procedure during the global period — do not invert these.

03Is 26951 used for open amputations or only direct closure?

26951 requires direct closure. If the wound is left open for delayed closure or requires a skin graft, a different code applies. The operative note must confirm direct closure to support this code.

04What is the global period for 26951 and what does it include?

26951 carries a 90-day global period. It bundles the surgery, the day-before pre-op visit if applicable, and all routine follow-up through day 90. Unrelated E/M services in that window require modifier 24; a staged planned procedure requires modifier 58.

05Why does my claim scrubber show 26951 as payable for only 1 unit?

Most scrubbers flag unit stacking on 26951 because the code is finger-specific. The MUE is 8, not 1. The fix is not modifier XS or 59 — it is reporting each digit on a separate claim line with the correct F-series finger modifier.

06Which specialties most commonly bill 26951?

General surgery and hand surgery account for the majority of 26951 claims per CMS Provider Utilization data. Orthopedic hand surgeons also bill this code frequently in trauma and tumor settings.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the amputated digit by name and side, the level of amputation (joint or phalanx), whether the procedure is primary or secondary, and confirmation of neurectomy and direct closure — the exact elements auditors check first. This prevents laterality-mismatch denials and ensures the operative note supports the digit-specific modifier required to bill multiple amputations in the same session.

See how Mira captures CPT 26951 documentation