CPT code 26116: Hand tumor excision, deep, under 1.5 cm2026 Medicare rate & RVUs

Medicare pays $494.00 for 26116 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 26116 covers

A hand surgeon, orthopedic surgeon, or plastic surgeon uses this code for excision of a soft-tissue tumor located beneath the fascia in the hand or a finger, with a tumor measuring less than 1.5 cm. The service involves surgically removing the mass; the operative report should establish its hand or finger location, deep position, and size. A specimen may be submitted for pathologic examination, but the code selection is based on the excision’s site, depth, and size rather than the eventual diagnosis.

Choose this code for a deep tumor under 1.5 cm, not a superficial mass or a larger deep tumor. Document the tumor’s dimensions and its relationship to the fascia. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 26116 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

26116 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 26116 rate is calculated

Each of 26116’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 26116

26116 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

26116 compared with similar codes

How to choose

26115Hand mass excisionSubcutaneous, under 1.5 cm

Use 26115 when the mass is subcutaneous. Use 26116 when it lies beneath the fascia; both represent the under-1.5-cm size level.

26113Hand tumor excisionDeep, 1.5 cm or larger

Both describe deep hand or finger tumor excision, but 26113 is for a tumor measuring 1.5 cm or more.

26160Tendon sheath excisionHand or finger lesion

26160 addresses a lesion arising from a tendon sheath or joint capsule. This code is for a deep soft-tissue tumor not classified by that specific origin.

26117Hand tumor resectionTumor under 3 cm

26117 describes radical resection of a hand tumor under 3 cm. Choose based on the operative extent and technique, not size alone.

Codes related to 26116

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates