No office rate
26100 is for biopsy of a carpometacarpal joint. Use 26105 for a metacarpophalangeal joint at the base of a finger.
On this page
CMS RVU26D · Effective 2026-10-01
26105 Joint biopsy Medicare reimbursement rates in Florida
Open biopsy of metacarpophalangeal joint lining, reported when tissue sampling is needed to evaluate unexplained synovitis, suspected infection, or another joint process. Compare 26105 office and facility rates across CMS payment localities in Florida.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26105 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$345.48–$388.96
3 of 3 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 26105 pays more and less in Florida
Hand surgery
About 26105: Metacarpophalangeal joint lining biopsy
Open biopsy of metacarpophalangeal joint lining, reported when tissue sampling is needed to evaluate unexplained synovitis, suspected infection, or another joint process.
This service involves surgically opening a metacarpophalangeal joint in the hand and taking a tissue sample from its lining for diagnostic evaluation. Hand and orthopedic surgeons may perform it when examination or imaging identifies abnormal joint-lining tissue and a tissue diagnosis is needed, such as in an evaluation of unexplained synovitis or suspected infection. The code is specific to the metacarpophalangeal joint, where a finger meets the hand.
Select the code based on the joint sampled: this code is for a metacarpophalangeal joint, not a carpometacarpal or interphalangeal joint. The operative report should identify the joint and side, describe the open biopsy, and document the indication and tissue obtained. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 applies to a bilateral procedure, paid at 150%. An assistant is paid only with documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26105
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.73 · 37%
- Practice expense (office) RVU5.66 · 56%
- Malpractice RVU0.80 · 8%
111
Medicare services in 2024 · #4793 by national volume
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.
26105 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
26110 applies to an interphalangeal joint within a finger; 26105 applies where the finger meets the hand.
$56.05–$61.51
20600 describes small-joint aspiration or injection. It does not describe surgically opening the joint to obtain a tissue biopsy.
No office rate
26130 describes removal of wrist-joint lining, not biopsy of a metacarpophalangeal joint.
Compare 26105 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$364.40
Miami →
Office / nonfacility
Unavailable
Facility
$388.96
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$345.48
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26105 billing questions
How does this differ from 26110?
26105 is for biopsy of a metacarpophalangeal joint, where a finger meets the hand. 26110 is for biopsy of an interphalangeal joint within a finger.
Is this the same as aspirating a finger joint?
No. This code describes an open tissue biopsy of the joint lining. Arthrocentesis code 20600 is used for aspiration or injection of a small joint or bursa.
What documentation supports reporting 26105?
Document the specific metacarpophalangeal joint and side, the clinical reason for tissue sampling, the open biopsy performed, and the tissue obtained.
Can modifier 50 be reported when both sides are biopsied?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150% when the procedure is performed bilaterally.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant at surgery payable?
CMS pays an assistant at surgery only when the claim is supported by documentation of medical necessity.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,54026075,,Explore/treat finger joint,A,,3.81,5.34,NA,5.34,,0.73,9.88,9.88,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54126080,,Explore/treat finger joint,A,,4.36,6.41,NA,6.41,,0.84,11.61,11.61,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54226100,,Biopsy hand joint lining,A,,3.70,5.65,NA,5.65,,0.79,10.14,10.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54326105,,Biopsy finger joint lining,A,,3.73,5.66,NA,5.66,,0.80,10.19,10.19,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54426110,,Biopsy finger joint lining,A,,3.56,5.28,NA,5.28,,0.68,9.52,9.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54526111,,Exc hand les sc 1.5 cm/>,A,,5.28,5.45,NA,5.45,,1.04,11.77,11.77,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54626113,,Exc hand tum deep 1.5 cm/>,A,,6.95,7.07,NA,7.07,,1.31,15.33,15.33,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00