CPT code 26020: Tendon sheath drainage2026 Medicare rate & RVUs in Illinois
Reports operative drainage of an infected hand tendon sheath, commonly for pyogenic tenosynovitis requiring surgical opening and irrigation.
CMS doesn’t publish an office rate for 26020 in Illinois.
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 26020 covers
This operation treats infection within a tendon sheath in the hand, often acute pyogenic flexor tenosynovitis. A hand, orthopedic, or plastic surgeon opens the involved sheath to drain infected material and may irrigate it. The operative setting is typical when infection requires surgical source control; this is not drainage of a superficial finger abscess or a trigger-finger release.
Report 26020 when the operative record identifies the tendon sheath as the infected space and documents the drainage performed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures occur 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 for this code. Medicare does not pay an assistant at surgery; 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 26020 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $591.63 |
| East St. Louis | Unavailable | $555.20 |
| Rest Of Illinois | Unavailable | $533.61 |
| Suburban Chicago | Unavailable | $574.58 |
How the 26020 rate is calculated
Each of 26020’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 · 26020
RVUs × geographic indexes × conversion factor
Work6.67
6.67 RVUs× 1.000 GPCI
Practice expense7.95
7.95 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
15.9300
Conversion factor
$33.4009
Medicare rate
$532.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26020
26020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26020
Tendon sheath drainage
| 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 · 26020
Tendon sheath 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26020 without 51 · national facility
$532.08
Tendon sheath drainage
26020-51 · Second procedure: 50%
$266.04
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%).
26020 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26010Abscess drainage
- 26010 addresses a finger abscess; use 26020 when the operative target is an infected tendon sheath.
- 26011Finger abscess drainage
- 26011 is for complicated finger abscess drainage. It does not represent drainage of infection within a tendon sheath.
- 26025Palm bursa drainage
- 26025 treats a palm bursa. Choose 26020 when the infected structure being drained is a hand tendon sheath.
- 26055Trigger finger release
- 26055 is associated with tendon-sheath incision for trigger finger. Code 26020 describes drainage for infection, not release for triggering.
26020 billing questions
How is 26020 distinguished from finger abscess drainage?
Use 26020 when the infected space is a tendon sheath. Codes 26010 and 26011 describe drainage of a finger abscess instead.
Does a trigger-finger release qualify as 26020?
No. Code 26020 is for drainage of an infected hand tendon sheath; 26055 is associated with tendon-sheath incision for trigger finger.
What documentation supports 26020?
The operative report should identify the involved tendon sheath, describe the infection and the drainage performed, and distinguish the sheath from a superficial abscess or palmar bursa.
Can modifier 50 be reported for both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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 50% multiple-procedure reduction. The 90-day global includes related postoperative care.
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
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