Billing code 26991: Bursa drainageMedicare rate & RVUs

Surgical drainage of an infected bursa in the pelvis or hip region, reported when the operative target is the bursa rather than superficial tissue or bone.

CMS RVU26DEffective Oct 1, 2026109 payment localities159 Medicare services in 2024

Medicare pays $744.84 for 26991 nationally in the office and $491.66 in a hospital or facility. Local office rates run $656.02–$955.10.

Medicare rate · 26991

Bursa drainage

Swap in your local Medicare rate.

Work RVUs
6.88
Total RVUs
22.30
Global days
090

National rate · 2026

$744.84

Office setting, before claim adjustments.

See every locality for 26991 → · 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 26991 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 26991 covers

This service involves surgically opening and draining an infected bursa in the pelvis or hip region. It is typically performed by an orthopedic surgeon in a hospital operating room when infection requires operative drainage. The operative report should identify the involved bursa and describe the drainage performed; a superficial collection or a bone lesion has a different target.

Report the code for drainage directed at the infected bursa, not merely because a collection is near the hip. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. 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 for this code. 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 26991 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$656.02 to $955.10

$656.02$805.56$955.10
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

26991 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$665.91$444.38
Alaska*$869.01$599.37
Arizona$723.55$478.22
Arkansas$656.02$438.54
Atlanta$762.48$505.25
Austin$767.07$499.21
Bakersfield$775.71$498.23
Baltimore/Surr. Cntys$793.84$522.18
Beaumont$699.38$468.99
Brazoria$732.11$481.21

26991 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.

$656.02

$869.01

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
26991 office rate range by state
State / territoryOffice rate rangeLocalities
AK$869.011
AL$665.911
AR$656.021
AZ$723.551
CA$771.82–$955.1029
CO$767.231
CT$795.361
DC$845.871
DE$735.621
FL$747.94–$836.033
GA$703.34–$762.482
GU$789.121
HI$789.121
IA$676.671
ID$682.591
IL$730.64–$809.784
IN$686.471
KS$676.561
KY$688.891
LA$689.05–$723.642
MA$763.76–$839.862
MD$748.89–$845.873
ME$689.60–$723.252
MI$710.20–$760.772
MN$725.261
MO$679.04–$722.473
MS$667.501
MT$744.751
NC$696.491
ND$716.871
NE$679.511
NH$758.141
NJ$801.65–$837.392
NM$715.471
NV$737.441
NY$707.46–$888.355
OH$704.511
OK$684.271
OR$728.98–$788.402
PA$703.88–$777.252
PR$749.281
RI$759.561
SC$702.211
SD$713.571
TN$680.451
TX$699.38–$767.078
UT$711.961
VA$723.04–$845.872
VI$749.281
VT$716.901
WA$761.37–$853.942
WI$692.601
WV$703.841
WY$732.601

How the 26991 rate is calculated

Each of 26991’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 · 26991

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.88Practice expense 14.01Malpractice 1.41

22.3000 adjusted RVUs×$33.4009 conversion factor=$744.84

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

Payment rules and modifiers for 26991

26991 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26991

Bursa drainage

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 · 26991

Bursa drainage

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

26991 without 51 · national office

$744.84

Bursa drainage

26991-51 · Second procedure: 50%

$372.42

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

26991 compared with similar codes

Compare codes

26991 vs 26990 vs 26992 vs 27030: national Medicare rates

Swap in your local Medicare rate.

  • 26991
    Bursa drainage · 6.88 wRVU
    $744.84
  • 26990
    Abscess drainage · 7.75 wRVU
    —
  • 26992
    Bone lesion drainage · 13.14 wRVU
    —
  • 27030
    Hip drainage · 13.31 wRVU
    —

How to choose

26990Abscess drainage
Choose 26990 for a superficial collection in the pelvis or hip area. This code is for drainage targeting an infected bursa.
26992Bone lesion drainage
Choose 26992 when the drainage targets a bone lesion. This code targets an infected bursa.
27030Hip drainage
27030 addresses operative drainage of the hip joint. This code is for an infected bursa in the pelvis or hip region.

26991 billing questions

How is this distinguished from drainage of a superficial pelvic or hip-area collection?

Use this code when the operative target is an infected bursa. A superficial collection is a different target and is represented by 26990.

When would drainage of a bone lesion be reported instead?

Code 26992 concerns drainage directed at a bone lesion. The operative documentation should make clear whether the target is the bursa or bone.

Does the 90-day global period include postoperative care?

Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 be used for bilateral drainage?

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

When is assistant-at-surgery payment allowed?

Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.

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 26991PPRRVU2026_Oct_nonQPP.csv, line 2,707 (RVU26D)

Open CMS sourceHow we calculate rates

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