CPT code 26750 – Closed treatment of distal phalanx fracture

Key takeaways

CPT code 26750 covers closed treatment of a distal phalanx fracture in a finger or thumb when no reduction is performed.

Each fractured digit gets its own claim line and digit modifier, such as F6 for the right index finger.

The first finger splint, coded 29130 or 29131, is bundled into the 90-day global package for 26750.

A same-day visit that leads to the fracture-care decision takes modifier 57, while modifier 25 is for an unrelated problem.

Pabau’s claims management software pre-fills the claim from the patient record and checks required fields before it goes out.

CPT code 26750 covers fingertip fractures that are never reduced

CPT code 26750 reports closed treatment of a distal phalanx fracture, finger or thumb, without manipulation, each.

The American Medical Association publishes the full descriptor as “Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each.” It sits in the Surgery section, under Hand and Fingers, in the 26720-26765 finger fracture family.

Two phrases decide whether it fits. “Closed treatment” means no incision, so the skin over the fracture stays intact. “Without manipulation” means nobody reduced the fracture. The last word, “each,” lets you bill 26750 once per fractured digit at the same encounter.

Tuft fractures are the classic 26750 case

The distal phalanx is the bone at the tip of each finger and the thumb. Breaks here are often called fingertip or terminal phalanx fractures. Crush injuries, a finger caught in a door, and ball sports cause most of them. A tuft fracture, where the very tip breaks into pieces, is the typical injury billed with CPT code 26750.

The 26750 visit is image, protect and follow up

Clinically, the work is short. The provider confirms the fracture on X-ray, decides it doesn’t need reducing, and protects it. There’s no incision, and no one repositions the bone. A typical encounter runs in five steps:

1. Take X-rays that show where the fracture is and how it’s aligned.
2. Record the assessment that the fracture is stable and nondisplaced or minimally displaced.
3. Apply a splint, such as an aluminum foam or stack splint, or use buddy taping.
4. Give the patient instructions on elevation, ice and activity limits.
5. Book a follow-up visit inside the global period to check healing.

“Without manipulation” is the phrase that makes or breaks the claim. If the provider tries to reduce the fracture, even partly, 26750 no longer applies. A closed reduction is 26755, which is closed treatment with manipulation. Pinning through the skin is 26756, and open treatment of a distal phalanx fracture is 26765.

Each treatment method has its own distal phalanx code

The finger fracture codes split by bone and by what the provider did to it. Auditors flag the wrong pick often, because the note has to show whether anyone attempted a reduction. Here’s how 26750 compares with its neighbors:

The fastest way to choose is to read what the note says happened to the bone, as the chart below shows.

The 26750 vs. 26755 call: A note that reads “nondisplaced, splinted” with no mention of reduction supports 26750. A note that reads “reduced under digital block” or “fracture repositioned” needs 26755. If the break is in the middle or proximal phalanx instead, start at 26720.

What 26750 bundles, and what you can still bill

Knowing the global package keeps you clear of unbundling denials. The table shows what’s included under most payer policies and what can go on its own line. Commercial contracts can differ from Medicare’s bundling rules, so check yours.

Modifiers for CPT code 26750 start with the digit

With 26750, modifiers carry as much weight as the code itself. Four come up again and again, and each answers a different question for the payer.

• Digit modifiers FA and F1-F9: These tell the payer which finger was treated. FA is the left thumb, and F1-F4 are the left second to fifth digits. F5 is the right thumb, and F6-F9 are the right second to fifth digits. LT and RT describe the hand, so they’re the wrong choice for a finger procedure.
• Modifier 57: 26750 is a major procedure with a 90-day global period. An evaluation and management (E&M) visit that leads to the decision for fracture care takes modifier 57. It applies on the day of the procedure or the day before.
• Modifier 25: Use it on a same-day E&M only when it’s significant, separately identifiable and unrelated to the fracture decision. Treating a separate problem, such as a scalp laceration from the same fall, is one example.
• Modifier 79: Use it for an unrelated procedure during the global period of an earlier 26750. A new fracture on a different finger is the common case.

Worked example: Two fingertips, one visit

A patient shuts a car door on their right hand. X-rays show nondisplaced tuft fractures of the index and middle fingers. The provider evaluates them, decides on splinting and splints both. The claim looks like this:

• E&M visit with modifier 57, because it led to the fracture-care decision.
• 26750-F6, linked to S62.660A for the right index finger.
• 26750-F7, linked to S62.662A for the right middle finger.
• 73140 for the finger X-rays.

The 90-day global period covers routine follow-up

CPT code 26750 carries a 090, or 90-day, global period on the Medicare Physician Fee Schedule. You can confirm the indicator each year in the CMS Physician Fee Schedule lookup tool. During those 90 days, these services are part of the package and can’t be billed separately without a modifier:

• Routine follow-up visits for the fracture, such as splint checks and progress reviews.
• Supplies normally used in fracture management, which varies by payer.
• Care for complications that come from the fracture treatment and don’t need a return to the operating room.

Run an insurance eligibility verification before each follow-up as well. A plan that changes mid-global period shifts who pays for the next service.

Modifiers 54 and 55 split care between providers

When care transfers mid-global period, the two providers split 26750. The provider who treats the fracture but won’t follow it adds modifier 54, Surgical Care Only.

The provider who takes over adds modifier 55, Postoperative Management Only. Both should document the transfer and its date. This happens most when urgent care hands the patient to an orthopedist.

ICD-10 codes that pair with CPT code 26750

Every 26750 line needs a supporting diagnosis from the ICD-10-CM code set. For fingers, use S62.66- for a nondisplaced distal phalanx fracture or S62.63- for a displaced one. For the thumb, use S62.52-. Each code needs the digit, the side and a 7th character for the encounter.

A common denial trigger: keeping the “A” character on follow-ups after active treatment ends. Once the patient is in routine healing, switch to “D.” Billing “A” past that point can prompt a medical necessity review.

Medicare pays 26750 on RVUs, not a flat fee

Medicare prices CPT code 26750 with relative value units (RVUs) under the resource-based relative value scale.

Work, practice expense and malpractice RVUs are each adjusted by the geographic practice cost index for your locality. The total is then multiplied by the annual conversion factor. You can look up the current values in the FastRVU 2026 RVU lookup tool.

Rates change with every annual fee schedule final rule. So never quote a dollar figure for 26750 without its calendar year and locality. Commercial allowables are negotiated separately and often differ from Medicare.

Documentation that holds up when 26750 is audited

Thin documentation is the most preventable cause of 26750 denials and recoupments. The note has to justify conservative care and show that no one manipulated the fracture. Auditors look for these six elements:

• Imaging report: An X-ray read that places the fracture in the distal phalanx and describes its alignment.
• Digit and side: The exact finger and hand, such as “right index finger, distal phalanx.” It must match the ICD-10 code and the digit modifier.
• Reason for no reduction: Why the provider judged the fracture stable enough to treat without manipulation.
• Splint or protection: The device used, such as an aluminum foam splint, stack splint or buddy tape, plus the patient’s instructions.
• Follow-up plan: When the patient should return, with a time frame that fits the global period.
• Matching superbill: The procedure code, diagnosis and modifier should agree across the superbill and the submitted claim.

Contradictions are what auditors catch first. If the note mentions a reduction attempt but the claim says 26750, expect a denial and possibly a recoupment.

Six errors that get 26750 claims denied

Once the documentation is solid, denials on 26750 come down to a short list of avoidable errors. A denial management workflow catches most of them before submission.

• Missing or wrong digit modifier: No FA-F9 modifier, or LT and RT where the payer expects a digit. Without digit modifiers, two 26750 lines look like a duplicate.
• Wrong ICD-10 encounter type: Using “A” on a routine healing visit instead of “D,” or sending “D” on the first fracture visit.
• Wrong modifier on the same-day visit: Billing the E&M that led to fracture care with modifier 25, or with none. That visit takes modifier 57. Modifier 25 is for a separate, unrelated problem.
• Global period conflict: Billing a follow-up office visit inside the 90-day global period without a modifier. The payer treats it as part of the package.
• Unspecified diagnosis: Sending an unspecified finger code, such as S62.669A, when the record names the digit and side.
• Splint code unbundling: Billing 29130 or 29131 for the first splint alongside 26750. NCCI bundles the initial splint, so the line is denied.

A pre-submission edit check, built into your clean claim process, stops missing modifiers and vague diagnoses before the payer sees them.

When a finger splint code can ride along with 26750

The finger splint codes are 29130 for a static splint and 29131 for a dynamic one. Whether either can go on a claim with 26750 depends on timing and the payer.

The AAPC Codify CPT lookup shows the NCCI code pairs that bundle. Check your payer’s own policy before adding a splint line to 26750, since commercial payers may not follow CMS.

Before you submit: A 26750 checklist

With the rules in place, the last step is a quick check before the claim leaves the practice. Run these six questions on every 26750 claim:

• Does the note say the fracture wasn’t reduced, and why?
• Is the digit named, and does the FA-F9 modifier match it?
• Is the diagnosis S62.66-, S62.63- or S62.52-, with the right 7th character?
• Is the first splint left off the claim?
• Does the same-day visit carry 57 or 25, based on what that visit decided?
• Is this date outside any open global period, or does it carry modifier 79?

How Pabau keeps 26750 claims moving

Many orthopedic and urgent care teams still retype each fracture visit into a clearinghouse portal. Every retyped field is another chance to drop a digit modifier or a 7th character.

Pabau, the practice management platform we build, fills the claim from the patient record instead. The CPT code on the service lands on the charge line, and the ICD-10 slots draw from the recorded diagnoses. Our claims management software won’t send a claim until its required fields are complete.

In the US, claims go out through Claim.MD with real-time eligibility checks. Payments come back as electronic remittances and post to the claim. So you can see which 26750 lines were paid, and which need a second look.

Send fracture care claims straight from the record

Pabau pre-fills CPT code 26750 claims from the patient record and checks required fields before submission. Claims go through Claim.MD with real-time eligibility checks and automatic remittance posting.

Book a demo

Conclusion

Treat 26750 as a documentation code first. When the note names the digit and says the fracture was splinted and never reduced, the coding follows.

The money is usually lost after the visit. A follow-up billed inside the 90 days, a 25 where a 57 belonged, or a first splint on its own line will each come back. Build those three checks into your routine, and these claims stop bouncing.

Book a demo to see how Pabau sends a 26750 claim from the patient record, with the eligibility check already done.

Continue your research

Need to verify claim submission workflows? Claim.MD clearinghouse overview explains how electronic claim routing and payer enrollment work through Pabau’s clearinghouse partner.

Seeing a pattern of denials on fracture care codes? Denial codes in medical billing covers the most common CARC and RARC codes and what each means for your appeal strategy.

Want to understand how ERAs map back to submitted claims? Electronic remittance advice (ERA) breaks down 835 file structure and how to reconcile remittances against 26750 and other fracture care claims.

Pinning a proximal or middle phalanx shaft fracture? CPT code 26727 covers percutaneous fixation of an unstable shaft fracture higher up the finger.

Frequently asked questions