Billing code 26034: Bone lesion surgeryMedicare rate & RVUs in Delaware
Reports surgical opening of a metacarpal or phalangeal cortex, typically to reach and drain a bone abscess or treat infection in the hand.
CMS doesn’t publish an office rate for 26034 in Delaware.
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 9 sections
What 26034 covers
The surgeon opens the outer layer of a metacarpal or finger bone to access a bone infection or abscess. A hand or orthopedic surgeon may perform the operation in a hospital or ambulatory surgery center. The operative report should identify the bone and site, the reason for surgery, and the work done at the bone; drainage of a finger abscess or treatment of a joint is a different service.
Report the code for the cortical bone work, not merely for a nearby soft-tissue incision. Documentation should support the diagnosis and describe the bone access and treatment performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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. Medicare does not pay an assistant at surgery for this code; 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.
26034 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $519.67 |
How the 26034 rate is calculated
Each of 26034’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 · 26034
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.46Practice expense 8.03Malpractice 1.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26034
26034 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26034
Bone lesion surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26034
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26034 without 51 · national facility
$526.06
Bone lesion surgery
26034-51 · Second procedure: 50%
$263.03
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%).
26034 compared with similar codes
Compare codes
26034 vs 26010 vs 26200 vs 26035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26010Abscess drainage
- 26010 is for drainage of a finger abscess in soft tissue. Use 26034 when the documented procedure includes opening the bone cortex.
- 26200Bone lesion removal
- 26200 addresses excision or curettage of a metacarpal bone cyst or benign tumor. This code describes cortical access for a different bone problem, such as infection.
- 26035Hand decompression
- 26035 is for decompression of the hand or fingers, not access to a metacarpal or phalangeal bone lesion.
26034 billing questions
How is this different from draining a finger abscess?
This code is for work that opens the cortex of a metacarpal or phalangeal bone. A soft-tissue finger abscess without that bone work is not reported with this code.
Is modifier 50 appropriate for bilateral treatment?
No. CMS identifies bilateral adjustment as inapplicable and modifier 50 as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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
Fee sheets
Put 26034 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →