Billing code
D004A — Metacarpal/phalangeal dislocation – closed reduction
Knuckle dislocation, closed reduction
Bill for putting a dislocated metacarpophalangeal (knuckle) joint back in place without surgery.
Watch for: Add E577 for each additional one; open reduction is D006.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $57.50 | $0.00 | $0.00 | $95.76 | $95.76 |
- Code
- D004A
- Description
- Metacarpal/phalangeal dislocation – closed reduction
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Closed reduction of a metacarpophalangeal dislocation. Add E577 for each additional one.
What it covers
D004 is closed reduction of a metacarpal/phalangeal dislocation (N15). Closed reduction means reducing the dislocation by non-operative methods, including traction (N1).
Each additional one is E577; open reduction is D006 (N15).
Billing rules
- Add E577 for each additional metacarpal/phalangeal dislocation reduced (N15).
- The major pre-operative visit (consultation or assessment) can be billed in addition (N1).
- Multiple fractures or dislocations: the major one is paid at 100%, the others at 85% (N1).
- Transferred for after-care: the physician who did the closed reduction claims 75% of the fee (N2).
- Surgical procedure: age premiums apply for patients under 16, from +10% (age 5–15) up to +30% (under 30 days) (GP64).
- Non-elective and done after hours: ED physicians billing H-codes add E412 (+20%, evenings/weekends/holidays) or E413 (+40%, 00:00–07:00); other physicians add E409 or E410 (GP104).
- FHO: a Schedule 4 office procedure that counts toward the office procedures special payment when done in your office for enrolled patients (Agreement p.92, §8.7).
Often billed with
- E577 for each additional dislocation (N15).
- E412 or E413 when an ED physician reduces it non-electively after hours (GP104).
Related codes: E577, D006, D001, E576, D007
Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Hand and Wrist, page N15; fracture and dislocation rules N1–N2.
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