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Billing code 26205: Bone lesion surgeryMedicare rate & RVUs

Reports curettage or excision of a benign cyst or tumor in a metacarpal when the resulting bone defect is filled with an autologous graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities16 Medicare services in 2024

Medicare pays $576.17 for 26205 nationally in a facility.

Medicare rate · 26205

Bone lesion surgery

Swap in your local Medicare rate.

Work RVUs
7.73
Total RVUs
17.25
Global days
090

National rate · 2026

$576.17

Facility setting, before claim adjustments.

See every locality for 26205 → · 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 26205 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 26205 covers

A hand surgeon treats a benign bone cyst or tumor in a metacarpal by removing or curetting the lesion and placing the patient’s own bone graft in the resulting defect. The graft is harvested as part of the service. This procedure is typically performed in an operating room, with the operative report identifying the metacarpal and describing lesion removal and graft placement.

Select this code when the treated bone is a metacarpal and an autologous graft is used; the no-graft code 26200 is the nearby choice when grafting is not performed. Document the lesion, its site, the removal technique, and graft use and harvest. Medicare 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 26205 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

26205 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$519.49
Alaska*Unavailable$697.77
ArizonaUnavailable$560.12
ArkansasUnavailable$512.49
AtlantaUnavailable$592.16
AustinUnavailable$585.70
BakersfieldUnavailable$584.92
Baltimore/Surr. CntysUnavailable$612.49
BeaumontUnavailable$548.59
BrazoriaUnavailable$563.81

26205 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
26205 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 26205 rate is calculated

Each of 26205’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 · 26205

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.73Practice expense 7.88Malpractice 1.64

17.2500 adjusted RVUs×$33.4009 conversion factor=$576.17

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

Payment rules and modifiers for 26205

26205 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26205

Bone lesion surgery

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 · 26205

Bone lesion surgery

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

26205 without 51 · national facility

$576.17

Bone lesion surgery

26205-51 · Second procedure: 50%

$288.09

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

26205 compared with similar codes

Compare codes

26205 vs 26200 vs 26215 vs 26230: national Medicare rates

Swap in your local Medicare rate.

  • 26205
    Bone lesion surgery · 7.73 wRVU
    —
  • 26200
    Bone lesion removal · 5.51 wRVU
    —
  • 26215
    Finger bone lesion · 7.09 wRVU
    —
  • 26230
    Hand bone excision · 6.31 wRVU
    —

How to choose

26200Bone lesion removal
Both address a metacarpal bone lesion, but 26205 includes autologous graft placement and harvest; 26200 is used when grafting is not performed.
26215Finger bone lesion
This code is for a metacarpal. Code 26215 is the corresponding grafted lesion procedure for a finger phalanx.
26230Hand bone excision
Code 26230 describes partial removal of metacarpal bone. Choose 26205 when the service is lesion curettage or excision with an autologous graft.

Codes related to 26205

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

Codes related to 26205
CodeHow it relatesNational office range
Same family
26200Bone lesion removalMetacarpal lesion treatment without the autologous graft included in 26205.No office rate
26210Bone lesion removalRelated lesion-removal code for a finger phalanx without the graft distinction.No office rate
26215Finger bone lesionFinger-phalanx lesion treatment with autograft rather than metacarpal treatment.No office rate
Used instead
26230Hand bone excisionPartial metacarpal excision is a different bone-removal approach from lesion curettage with grafting.No office rate

26205 billing questions

When should 26205 be chosen over 26200?

Use 26205 for a metacarpal lesion when an autologous bone graft is placed after lesion removal. Code 26200 is the nearby option when no graft is used.

Can the bone graft harvest be billed separately?

The graft harvest is included in this service. The operative documentation should establish that the graft was autologous and placed in the metacarpal defect.

Does modifier 50 apply if lesions are treated on both hands?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

How does the 90-day global period affect follow-up visits?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical package.

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; 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 26205PPRRVU2026_Oct_nonQPP.csv, line 2,563 (RVU26D)

Open CMS sourceHow we calculate rates

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