CPT code 26160: Tendon sheath excision, hand or finger lesion2026 Medicare rate & RVUs

Reports surgical removal of a lesion arising from a hand or finger tendon sheath or joint capsule, such as a ganglion or cyst.

CMS RVU26DEffective Oct 1, 2026109 payment localities25.6K Medicare services in 2024

Medicare pays $657.66 for 26160 nationally in the office and $308.62 in a hospital or facility. Local office rates run $573.74–$889.79.

Medicare rate · 26160

Tendon sheath excision, hand or finger lesion

Office or facility?

Work RVUs
3.48
Total RVUs
19.69
Global days
090

National rate · 2026

$657.66

Office setting, before claim adjustments.

See every locality for 26160 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 26160 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26160 covers

A hand surgeon removes a lesion attached to a tendon sheath or joint capsule in the hand or finger. A common example is a ganglion arising from a finger tendon sheath; cystic or other localized lesions may also be treated. The service is typically performed by an orthopedic or plastic surgeon in an operating room or ambulatory surgery setting, with the lesion separated from the involved sheath or capsule and removed.

Select this code when the operative findings identify the lesion as arising from the tendon sheath or joint capsule, rather than as a separate superficial or deep soft-tissue mass. Document the involved structure, location, lesion, and excision. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily 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 26160 pays more and less

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

109 payment localities

$573.74 to $889.79

$573.74$731.76$889.79
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

26160 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$583.17$277.76
Alaska$739.64$367.92
Arizona$638.39$300.17
Arkansas$573.74$273.91
Atlanta, GA$670.75$316.13
Austin, TX$685.51$316.22
Bakersfield, CA$701.11$318.57
Baltimore area, MD$702.66$328.14
Beaumont, TX$609.35$291.73
Brazoria, TX$649.07$303.17

26160 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$573.74

$794.53

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
26160 office rate range by state
State / territoryOffice rate rangeLocalities
AK$739.641
AL$583.171
AR$573.741
AZ$638.391
CA$699.27–$889.7929
CO$687.471
CT$704.611
DC$758.881
DE$649.791
FL$645.90–$712.663
GA$605.80–$670.752
GU$719.541
HI$719.541
IA$600.221
ID$604.501
IL$624.89–$689.624
IN$608.421
KS$596.871
KY$598.141
LA$597.01–$630.022
MA$682.58–$760.762
MD$663.25–$758.883
ME$607.78–$644.852
MI$615.32–$654.612
MN$657.211
MO$585.42–$632.783
MS$579.721
MT$657.621
NC$614.911
ND$644.571
NE$603.961
NH$676.201
NJ$712.23–$749.592
NM$618.991
NV$654.501
NY$625.15–$782.165
OH$612.651
OK$597.171
OR$649.04–$711.532
PA$613.86–$685.312
PR$663.051
RI$674.631
SC$614.881
SD$643.031
TN$600.191
TX$609.35–$685.518
UT$624.251
VA$642.35–$758.882
VI$663.051
VT$641.581
WA$681.43–$777.342
WI$620.591
WV$599.131
WY$651.931

How the 26160 rate is calculated

Each of 26160’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.

How the rate is built · 26160

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.48

3.48 RVUs× 1.000 GPCI

Practice expense15.55

15.55 RVUs× 1.000 GPCI

Malpractice0.66

0.66 RVUs× 1.000 GPCI

Adjusted RVUs

19.6900

Conversion factor

$33.4009

Medicare rate

$657.66

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26160

26160 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26160

Tendon sheath excision, hand or finger lesion

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26160

Tendon sheath excision, hand or finger lesion

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26160 without 51 · national office

$657.66

Tendon sheath excision, hand or finger lesion

26160-51 · Second procedure: 50%

$328.83

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

26160 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26160

    Tendon sheath excision, hand or finger lesion3.48 wRVU

    $657.66

  • 26111

    Hand mass excision, subcutaneous, 1.5 cm or larger5.28 wRVU

    Not priced

  • 26113

    Hand tumor excision, deep, 1.5 cm or larger6.95 wRVU

    Not priced

  • 26145

    Tenosynovectomy, palm or finger, each tendon6.33 wRVU

    Not priced

How to choose

26111Hand mass excisionSubcutaneous, 1.5 cm or larger
This code targets a lesion arising from a tendon sheath or joint capsule. 26111 is for a subcutaneous hand lesion meeting its size criterion.
26113Hand tumor excisionDeep, 1.5 cm or larger
Use this code for a sheath- or capsule-based lesion. 26113 addresses a deep hand tumor meeting its size criterion.
26145TenosynovectomyPalm or finger, each tendon
26145 involves excision of a tendon in the palm or finger. This code removes a lesion arising from the tendon sheath or joint capsule, not the tendon itself.

26160 billing questions

How is this different from excision of a hand soft-tissue mass?

Use this code when the lesion arises from a tendon sheath or joint capsule. Codes for hand masses are selected according to the mass's tissue plane and, for some codes, size.

Can a ganglion from a finger tendon sheath be reported with this code?

Yes, when the surgeon excises a ganglion arising from the tendon sheath. The operative note should identify the origin and the structure from which it was removed.

Should modifier 50 be used for lesions on both hands?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the 90-day global period affect postoperative visits?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

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

Show the CMS file lines behind this rate
RVUs for 26160PPRRVU2026_Oct_nonQPP.csv, line 2,558 (RVU26D)

Open CMS sourceHow we calculate rates

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