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Billing code 26110: Joint biopsyMedicare rate & RVUs

Reports surgical sampling of the lining of a finger joint when tissue is needed to investigate a joint disorder such as persistent synovitis.

CMS RVU26DEffective Oct 1, 2026109 payment localities504 Medicare services in 2024

Medicare pays $317.98 for 26110 nationally in a facility.

Medicare rate · 26110

Joint biopsy

Swap in your local Medicare rate.

Work RVUs
3.56
Total RVUs
9.52
Global days
090

National rate · 2026

$317.98

Facility setting, before claim adjustments.

See every locality for 26110 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 26110 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 26110 covers

A surgeon obtains a tissue sample from the synovial lining of a finger joint for diagnostic examination. This may be considered when clinical evaluation has not established the cause of persistent joint inflammation or when tissue findings are needed to assess suspected inflammatory, infectious, or proliferative disease. Hand and orthopedic surgeons typically perform the procedure in an operating room or other surgical setting, with the specimen submitted for pathology.

Select this service when the operative report identifies a biopsy of the finger joint lining, rather than removal of a separate soft-tissue mass or treatment of the joint itself. Documentation should identify the finger and joint, the tissue sampled, the reason for biopsy, and the specimen sent for examination. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 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 26110 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

26110 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$286.07
Alaska*Unavailable$378.70
ArizonaUnavailable$309.24
ArkansasUnavailable$282.09
AtlantaUnavailable$325.72
AustinUnavailable$325.85
BakersfieldUnavailable$328.29
Baltimore/Surr. CntysUnavailable$338.14
BeaumontUnavailable$300.49
BrazoriaUnavailable$312.34

26110 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
26110 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 26110 rate is calculated

Each of 26110’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 · 26110

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.56Practice expense 5.28Malpractice 0.68

9.5200 adjusted RVUs×$33.4009 conversion factor=$317.98

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 26110

26110 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26110

Joint biopsy

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 · 26110

Joint biopsy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

26110 without 51 · national facility

$317.98

Joint biopsy

26110-51 · Second procedure: 50%

$158.99

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

26110 compared with similar codes

Compare codes

26110 vs 26100 vs 26105 vs 26111: national Medicare rates

Swap in your local Medicare rate.

  • 26110
    Joint biopsy · 3.56 wRVU
    —
  • 26100
    Joint biopsy · 3.7 wRVU
    —
  • 26105
    Joint biopsy · 3.73 wRVU
    —
  • 26111
    Hand mass excision · 5.28 wRVU
    —

How to choose

26100Joint biopsy
26100 identifies biopsy of hand joint lining; 26110 is specific to finger joint lining. Base code selection on the joint site in the operative report.
26105Joint biopsy
Both nearby descriptors refer to finger-joint lining biopsy. Confirm the exact documented procedure and current code descriptor before choosing between them.
26111Hand mass excision
26111 is for excision of a subcutaneous hand or finger lesion, not sampling of synovial tissue within a finger joint.

Codes related to 26110

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

Codes related to 26110
CodeHow it relatesNational office range
Same family
26100Joint biopsyBiopsy of hand joint lining; distinguish by the documented joint site.No office rate
26105Joint biopsyA nearby finger-joint lining biopsy code; verify the specific procedure and site documentation.No office rate
Used instead
26111Hand mass excisionSubcutaneous hand or finger lesion excision, rather than diagnostic sampling of joint lining.No office rate
26115Hand mass excisionSubcutaneous hand or finger lesion excision at a different size level.$514.82–$782.67

26110 billing questions

How does this differ from code 26100?

Code 26110 is for sampling the lining of a finger joint. Code 26100 identifies biopsy of the lining of a hand joint; use the code that matches the documented anatomic site.

Is this code appropriate for removing a finger mass?

Use 26110 when the procedure samples finger-joint lining for diagnosis. A separately excised soft-tissue lesion is a different service; codes 26111 and 26115 describe subcutaneous hand or finger lesion excision by size.

What documentation supports reporting the biopsy?

The operative note should identify the finger joint, the lining tissue sampled, the diagnostic reason for sampling, and the specimen submitted for pathology.

Can modifier 50 be used for biopsies on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50 to report bilateral performance.

How are other procedures in the same session paid?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction. Related postoperative care is included in the 90-day global period.

Is an assistant or co-surgeon payable?

CMS restricts assistant-at-surgery payment for this service and does not permit co-surgeon or team-surgery reporting.

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 26110PPRRVU2026_Oct_nonQPP.csv, line 2,544 (RVU26D)

Open CMS sourceHow we calculate rates

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