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CPT code 26200: Bone lesion removal2026 Medicare rate & RVUs

Reports excision or curettage of a cyst or benign tumor in a metacarpal when the surgeon treats the lesion without the grafting service.

CMS RVU26DEffective Oct 1, 2026109 payment localities179 Medicare services in 2024

Medicare pays $429.20 for 26200 nationally in a facility.

Medicare rate · 26200

Bone lesion removal

Office or facility?

Work RVUs
5.51
Total RVUs
12.85
Global days
090

National rate · 2026

$429.20

Facility setting, before claim adjustments.

See every locality for 26200 →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 26200 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 26200 covers

A hand or orthopedic surgeon uses this service to remove or curette a bone cyst or benign tumor in a metacarpal. The operation may involve opening the affected bone and removing the lesion; the resulting specimen may be submitted for pathologic examination. These cases are commonly performed in a hospital or ambulatory surgery setting when a metacarpal lesion requires operative treatment.

Select the code based on the treated bone and the procedure performed. Document the metacarpal involved, the lesion and its location, the removal or curettage, and whether grafting was performed. This code has 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 others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 26200 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

26200 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$387.41
AlaskaUnavailable$518.62
ArizonaUnavailable$417.53
ArkansasUnavailable$382.22
Atlanta, GAUnavailable$440.35
Austin, TXUnavailable$437.58
Bakersfield, CAUnavailable$438.67
Baltimore area, MDUnavailable$455.96
Beaumont, TXUnavailable$407.82
Brazoria, TXUnavailable$420.86

26200 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
26200 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 26200 rate is calculated

Each of 26200’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 · 26200

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.51

5.51 RVUs× 1.000 GPCI

Practice expense6.26

6.26 RVUs× 1.000 GPCI

Malpractice1.08

1.08 RVUs× 1.000 GPCI

Adjusted RVUs

12.8500

Conversion factor

$33.4009

Medicare rate

$429.20

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

Payment rules and modifiers for 26200

26200 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26200

Bone lesion removal

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)0Not paid without supporting documentation.
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 · 26200

Bone lesion removal

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

26200 without 51 · national facility

$429.20

Bone lesion removal

26200-51 · Second procedure: 50%

$214.60

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

26200 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26200

    Bone lesion removal5.51 wRVU

    Not priced

  • 26205

    Bone lesion surgery7.73 wRVU

    Not priced

  • 26210

    Bone lesion removal5.19 wRVU

    Not priced

  • 26230

    Hand bone excision6.31 wRVU

    Not priced

How to choose

26205Bone lesion surgery
This code includes the grafting service for metacarpal lesion treatment; 26200 describes lesion removal or curettage without that grafting service.
26210Bone lesion removal
Use 26210 for a bone cyst or benign tumor in a finger phalanx. Code 26200 is for a metacarpal.
26230Hand bone excision
26230 describes partial excision of a metacarpal, rather than removal or curettage directed at a bone cyst or benign tumor.

Codes related to 26200

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

Codes related to 26200
CodeHow it relatesNational office range
Same family
26205Bone lesion surgeryRelated metacarpal lesion treatment when grafting is included.No office rate
26210Bone lesion removalLesion excision or curettage in a finger phalanx rather than a metacarpal.No office rate
26215Finger bone lesionFinger phalanx lesion treatment with grafting.No office rate

26200 billing questions

When is 26200 used instead of 26205?

Use 26200 for metacarpal lesion removal or curettage without the grafting service. When bone grafting is part of the lesion treatment, consider 26205.

Can 26200 be reported for a finger phalanx lesion?

No. This code is for a metacarpal; lesion treatment in a finger phalanx is represented by the related phalanx codes, such as 26210 or 26215.

Is modifier 50 appropriate for lesions in both hands?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What documentation supports reporting 26200?

Document the metacarpal treated, the lesion and its location, and the operative work removing or curetting it. Note whether grafting was performed to support selection between lesion-treatment codes.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. The code also carries a 90-day global period for related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 26200PPRRVU2026_Oct_nonQPP.csv, line 2,562 (RVU26D)

Open CMS sourceHow we calculate rates

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