Finger or thumb amputation at any joint or phalanx level — primary or secondary — with neurectomy and local advancement flap (V-Y or hood flap) closure.

Verified May 8, 2026 · 5 sources ↓

Medicare: $667.68
Work RVU: 6.32
Global, days: 90
Region: Hand

Drawn from CMSAAPCEatonhandFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify primary vs. secondary amputation and the clinical indication (trauma, infection, failed prior healing).
Identify the exact digit(s) by name and laterality (e.g., left hand, fifth digit).
Document the joint or phalanx level at which amputation was performed.
Confirm the closure technique by name — V-Y flap, hood flap, or other local advancement flap — to support 26952 over 26951.
Record that neurectomy was performed as part of the procedure.
Note any concurrent procedures on separate digits with distinct documentation for each.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same 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 ↓

26952 covers surgical removal of a finger or thumb at any joint or phalanx, whether performed immediately after acute injury or infection (primary) or after a prior amputation that failed to heal (secondary). The procedure includes neurectomy and is distinguished from 26951 by the closure method: 26952 requires a local advancement flap such as a V-Y or hood flap. If the surgeon used direct closure, 26951 applies. That distinction is the most common code-selection error in this family.

The 90-day global period means all routine post-operative management through day 90 is bundled. Unrelated E/M visits in that window need modifier 24. When multiple digits are amputated in the same session, use digit-specific finger modifiers (F1–F9, FA) along with modifier 51 to identify each involved digit and signal multiple procedures. NCCI bundles simple wound repair codes (e.g., 12001) into 26952 when performed on the same digit — unbundle only when a separate digit is addressed, using the appropriate finger modifier plus modifier 59 or XS.

Site of service matters here. The HOPD and ASC facility payment rates differ substantially (see the Site of Service comparison table). Many of these cases land in the ED or OR under trauma circumstances; confirm the place-of-service code on the claim matches where the procedure was actually performed, since mismatches are a common reason for underpayment rather than outright denial.

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 (6.32) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (19.99) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.32
Practice expense RVU	12.44
Malpractice RVU	1.23
Total RVU	19.99
Medicare national rate	$667.68
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	$667.68
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 26952 get rejected.

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

Wrong code selected — 26951 billed when operative note describes local advancement flap closure, or 26952 billed when direct closure was used.
Missing or vague closure documentation — operative notes that say 'flap closure' without specifying the advancement technique trigger downcoding or medical review requests.
Finger modifier absent or incorrect — claims for multi-digit amputations without digit-specific modifiers are returned or bundled incorrectly.
NCCI edit triggered when wound repair on the same digit is billed alongside 26952 without modifier 59 or XS, and without documentation that a separate digit was involved.
Place-of-service mismatch — procedure performed in the ED or ASC but billed under the wrong facility type, causing payment at the wrong rate.

Frequently asked questions

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

01What separates 26952 from 26951?

The closure method. 26951 is direct closure; 26952 requires a local advancement flap such as a V-Y or hood flap. The amputation level and neurectomy are the same in both — only the closure differentiates them.

02Can I bill 26952 for a secondary amputation after a failed replant?

Yes. Secondary amputation — performed because a prior amputation or replant failed to heal properly — is explicitly included in 26952. Document the prior procedure and the reason for revision clearly in the operative note.

03Which finger modifiers apply, and does Medicare accept them?

Use FA (thumb left), F1–F5 (left fingers), F6 (thumb right), F7–F9 (right fingers) to identify the specific digit. Some MACs process these modifiers; others, including some Medicare carriers, do not. Check your MAC's policy before relying on finger modifiers to override an NCCI edit.

04How do I bill when two separate digits are amputated in the same session?

Bill 26952 with the appropriate finger modifier for the primary digit, then 26952-51 with the finger modifier for the second digit. Document each digit separately in the operative note, including closure technique for each.

05A wound repair was done on an adjacent finger at the same encounter. Is it billable?

Only if it was performed on a different digit. NCCI bundles wound repair codes like 12001 into 26952 for the same digit. When the repair is on a separate finger, append modifier 59 or XS and the correct finger modifier to the wound repair code.

06What global period applies, and what modifiers are needed for post-op visits?

26952 carries a 90-day global period. Routine post-op care through day 90 is bundled — don't bill E/M separately for wound checks or stitch removal. If a patient presents within the global for an unrelated problem, use modifier 24 on the E/M. An unrelated surgical procedure in the global needs modifier 79.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the amputation level (joint or phalanx), digit name and laterality, primary vs. secondary classification, and the specific closure technique used — V-Y flap, hood flap, or other local advancement flap. It also flags neurectomy language in the dictation. That prevents the single most common audit finding in this code family: an operative note that documents flap closure generically, leaving reviewers unable to distinguish 26952 from 26951 and triggering a downcode.

See how Mira captures CPT 26952 documentation