Billing code 26230: Hand bone excisionMedicare rate & RVUs

Medicare pays $471.62 for 26230 nationally in a facility.

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

What 26230 covers

A hand or orthopedic surgeon removes part of a metacarpal, one of the long bones of the hand. The procedure may be performed to remove diseased bone, such as bone affected by osteomyelitis, in an operating room or another surgical setting. This code describes partial removal of the metacarpal, rather than a targeted excision or curettage of a bone cyst or benign tumor.

Select the code when the operative report supports partial excision of a metacarpal; document the specific bone, the portion removed, the indication, and the operative work. The 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of 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 26230 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

26230 rates by state

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

How the 26230 rate is calculated

Each of 26230’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.

Payment rules and modifiers for 26230

26230 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

26230 compared with similar codes

How to choose

26200Bone lesion removal

26200 is for excision or curettage of a metacarpal bone cyst or benign tumor. Use 26230 when the documented service is partial removal of the metacarpal.

26205Bone lesion surgery

26205 covers metacarpal bone cyst or benign tumor excision or curettage with bone grafting. The key distinction is the lesion-directed service and grafting, not partial metacarpal excision alone.

26235Finger bone surgery

26235 describes partial excision of a finger phalanx. Choose based on the bone treated: a metacarpal for 26230 or a phalanx for 26235.

26250Hand tumor resection

26250 is for radical resection of a metacarpal tumor. Code 26230 describes partial metacarpal excision, not radical tumor resection.

Codes related to 26230

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

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

Open CMS sourceHow we calculate rates