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

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, 2026One payment locality25.6K Medicare services in 2024

In Ohio, Medicare pays $612.65 for 26160 in the office and $293.98 when it’s performed in a hospital or facility.

$612.65Office (non-facility)
$293.98Hospital or facility
−6.8%vs the national office rate ($657.66)

Check a contract rate as a % of Medicare · 26160 nationwide

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

We’ll open 26160 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Ohio
  2. What 26160 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Ohio compares for 26160

Across 109 of 109 payment localities, the office rate for 26160 runs from $573.74 in Arkansas to $889.79 in San Benito County, CA. Ohio pays $612.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

26160 in Ohio vs other payment areas
  1. Ohio · this page$612.65
  2. Los Angeles, CA · California$750.07+$137.42
  3. Washington, DC area · District of Columbia$758.88+$146.23
  4. Miami, FL · Florida$712.66+$100.01
  5. Chicago, IL · Illinois$689.62+$76.97
  6. Manhattan, NY · New York$762.16+$149.51
  7. Alaska · Alaska$739.64+$126.99

Other areas in Ohio first, then benchmark localities. Bars start at $0.

Every other payment area

26160 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$583.17$277.76
ArkansasArkansas$573.74$273.91
ArizonaArizona$638.39$300.17
Bakersfield, CACalifornia$701.11$318.57
Chico, CACalifornia$699.27$316.72
El Centro, CACalifornia$699.38$316.83
Fresno, CACalifornia$699.27$316.72
Hanford, CACalifornia$699.27$316.72

26160 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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

See 26160 in every payment locality

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.

The exact Ohio inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,558

Code
26160
Physician work
3.48
Practice expense
15.55
Malpractice
0.66

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 26160 in Ohio
ComponentRVULocality factorAdjusted
Physician work3.48× 1.0003.4800
Practice expense15.55× 0.91314.1972
Malpractice0.66× 1.0080.6653
Total RVUs18.3424
Conversion factor× 33.4009

Office rate, Ohio$612.65

Office: (3.48 × 1 + 15.55 × 0.913 + 0.66 × 1.008) × $33.4009 = $612.65

Facility: (3.48 × 1 + 5.1 × 0.913 + 0.66 × 1.008) × $33.4009 = $293.98

Open 26160 in the RVU calculator

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

Codes related to 26160

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

Codes related to 26160
CodeHow it relatesOffice range, Ohio
Used instead
26111Hand mass excision, subcutaneous, 1.5 cm or largerFor a qualifying subcutaneous hand lesion rather than a tendon-sheath or capsule lesion.No office rate
26115Hand mass excision, subcutaneous, under 1.5 cmFor a smaller subcutaneous hand lesion when the lesion is not sheath- or capsule-based.$550.61
26113Hand tumor excision, deep, 1.5 cm or largerFor a qualifying deep hand tumor rather than a lesion arising from the tendon sheath or capsule.No office rate
26116Hand tumor excision, deep, under 1.5 cmFor a smaller deep hand tumor when the operative target is not the tendon sheath or capsule.No office rate
26145Tenosynovectomy, palm or finger, each tendonFor excision of a palm or finger tendon itself, rather than a lesion of its sheath.No office rate

How 26160 has changed in Ohio

26160 · Office / nonfacility

$612.65

Effective 2026-10-01

The base rate is $57.56 higher than on 2025-10-01, moving from $555.09 to $612.65 (10.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $555.09changed to$612.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.57 changed to 3.48
    • Practice expense RVU 14.17 changed to 15.55
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $577.38changed to$555.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.35 changed to 14.17
    • Malpractice RVU 0.68 changed to 0.66

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $567.96changed to$577.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $591.33changed to$567.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.45 changed to 14.35
    • Malpractice RVU 0.66 changed to 0.68
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033

  5. January 1, 2023

    RVU23A

    $604.77changed to$591.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 14.44 changed to 14.45
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $594.05changed to$604.77

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.97 changed to 14.44
    • Malpractice RVU 0.64 changed to 0.66

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $553.58changed to$594.05

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.14 changed to 13.97
    • Malpractice RVU 0.63 changed to 0.64
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $563.32changed to$553.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.44 changed to 12.14
    • Malpractice RVU 0.65 changed to 0.63
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $555.47changed to$563.32

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.21 changed to 12.44
    • Malpractice RVU 0.66 changed to 0.65

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $549.44changed to$555.47

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.07 changed to 12.21
    • Practice expense GPCI 0.918 changed to 0.917
    • Malpractice GPCI 0.999 changed to 1.005

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $547.71changed to$549.44

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.05 changed to 12.07
    • Malpractice RVU 0.67 changed to 0.66
    • Malpractice GPCI 0.993 changed to 0.999

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $550.34changed to$547.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.07 changed to 12.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $547.60changed to$550.34

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $545.50changed to$547.60

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.88 changed to 12.07
    • Malpractice RVU 0.62 changed to 0.67
    • Practice expense GPCI 0.923 changed to 0.918
    • Malpractice GPCI 1.117 changed to 0.993

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $565.20changed to$545.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.20 changed to 11.88
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.240 changed to 1.117

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $565.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$612.65$293.98RVU26D
2026-07-01$612.65$293.98RVU26C
2026-04-01$612.65$293.98RVU26B
2026-01-01$612.65$293.98RVU26A
2025-10-01$555.09$302.84RVU25D
2025-07-01$555.09$302.84RVU25C
2025-04-01$555.09$302.84RVU25B
2025-01-01$555.09$302.84RVU25A
2024-10-01$577.38$308.70RVU24D
2024-07-01$577.38$308.70RVU24C
2024-04-01$577.38$308.70RVU24B
2024-03-09$577.38$308.70RVU24AR
2024-01-01$567.96$303.66RVU24A
2023-10-01$591.33$311.02RVU23D
2023-07-01$591.33$311.02RVU23C
2023-04-01$591.33$311.02RVU23B
2023-01-01$591.33$311.02RVU23A
2022-10-01$604.77$312.20RVU22D
2022-07-01$604.77$312.20RVU22C
2022-04-01$604.77$312.20RVU22B
2022-01-01$604.77$312.20RVU22A
2021-10-01$594.05$312.43RVU21D
2021-07-01$594.05$312.43RVU21C
2021-04-01$594.05$312.43RVU21B
2021-01-01$594.05$312.43RVU21A
2020-10-01$553.58$312.52RVU20D
2020-07-01$553.58$312.52RVU20C
2020-04-01$553.58$312.52RVU20B
2020-01-01$553.58$312.52RVU20A
2019-10-01$563.32$329.67RVU19D
2019-07-01$563.32$329.67RVU19C
2019-04-01$563.32$329.67RVU19B
2019-01-01$563.32$329.67RVU19A
2018-10-01$555.47$329.34RVU18D
2018-07-01$555.47$329.34RVU18C
2018-04-01$555.47$329.34RVU18B
2018-01-01$555.47$329.34RVU18AR1
2017-10-01$549.44$326.73RVU17D
2017-07-01$549.44$326.73RVU17C
2017-04-01$549.44$326.73RVU17B
2017-01-01$549.44$326.73RVU17A
2016-10-01$547.71$325.52RVU16D
2016-07-01$547.71$325.52RVU16C
2016-04-01$547.71$325.52RVU16B
2016-01-01$547.71$325.52RVU16A
2015-10-01$550.34$326.36RVU15D
2015-07-01$550.34$326.36RVU15C
2015-04-01$547.60$324.74RVU15B
2015-01-01$547.60$324.74RVU15A
2014-10-01$545.50$325.29RVU14D
2014-07-01$545.50$325.29RVU14C
2014-04-01$545.50$325.29RVU14B
2014-01-01$545.50$325.29RVU14A
2013-10-01$565.20$330.24RVU13D
2013-07-01$565.20$330.24RVU13C
2013-04-01$565.20$330.24RVU13B
2013-01-01$565.20$330.24RVU13AR

Price 26160 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

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)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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