Billing code
F005A — Phalanx fracture – closed reduction
Finger fracture, closed reduction
Bill for closed (non-operative) reduction of a phalanx fracture; add E558 for each additional phalanx.
Watch for: Repeat reductions: earlier ones by the same surgeon pay 85%; transferring after-care means claiming 75%.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $99.25 | $0.00 | $0.00 | $95.76 | $95.76 |
- Code
- F005A
- Description
- Phalanx fracture – 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 fractured phalanx (finger or toe bone). Add E558 for each additional phalanx.
What it covers
F005 is closed reduction of a phalanx fracture (N14). Closed reduction means reducing the fracture by non-operative methods, including traction (N1).
A phalanx fracture treated with no reduction and custom rigid immobilization is F004; open reduction is F007; each additional phalanx is E558 (N14).
Billing rules
- Add E558 for each additional phalanx fracture reduced (N14).
- Percutaneous pinning: add E826 (+75%); E569 is not payable with E826 (N3).
- The major pre-operative visit (consultation or assessment) can be billed in addition (N1).
- Repeat reductions of the same fracture: the final one is paid in full, earlier ones by the same surgeon at 85% (N2).
- Transferred for after-care: the physician who did the closed reduction claims 75% (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
- E558 for each additional phalanx (N14).
- E826 for percutaneous pinning (N3).
- E412 or E413 when an ED physician reduces it non-electively after hours (GP104).
Related codes: F004, F007, E558, E826, F006, F009
Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Hand and Wrist, page N14; fracture rules N1–N3.
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