No office rate
Use 26105 for biopsy of a metacarpophalangeal joint lining. Code 26100 is for the carpometacarpal joint at the base of the hand.
On this page
CMS RVU26D · Effective 2026-10-01
26100 Joint biopsy Medicare reimbursement rates in Kansas
Reports an open biopsy of the carpometacarpal joint lining when a hand surgeon obtains tissue to investigate a joint disorder. Compare 26100 office and facility rates across CMS payment localities in Kansas.
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 26100 in Kansas?
Kansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$307.48
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
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.
Hand surgery
About 26100: Carpometacarpal joint lining biopsy
Reports an open biopsy of the carpometacarpal joint lining when a hand surgeon obtains tissue to investigate a joint disorder.
A hand surgeon opens the carpometacarpal joint at the base of the hand and takes a sample of its lining for diagnostic evaluation. The procedure may be performed in a hospital operating room or another surgical setting when a tissue sample is needed to investigate an abnormal joint process. The service is a biopsy, not removal of the joint lining as treatment and not a biopsy of a finger joint.
Report the code for the carpometacarpal joint and document the specific site, the open joint approach, and that lining tissue was sampled. This code has a 90-day global period, which includes 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 others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26100
- 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 RVU3.70 · 36%
- Practice expense (office) RVU5.65 · 56%
- Malpractice RVU0.79 · 8%
25
Medicare services in 2024 · #5777 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.
26100 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Use 26110 for biopsy of an interphalangeal joint lining. Code 26100 identifies the carpometacarpal joint, not a finger joint.
No office rate
Code 26100 describes diagnostic sampling of the carpometacarpal joint lining. Code 26130 describes therapeutic removal of joint lining by synovectomy.
Compare 26100 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.
1 of 1 payment localities
Kansas →
Office / nonfacility
Unavailable
Facility
$307.48
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 26100 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,542
- Code
- 26100
- Physician work
- 3.70
- Practice expense
- 5.65
- Malpractice
- 0.79
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.70 | × 1.000 | 3.7000 |
| Practice expense | 5.65 | × 0.904 | 5.1076 |
| Malpractice | 0.79 | × 0.504 | 0.3982 |
| Total RVUs | 9.2058 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$307.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.7 | 1 |
| Practice expense | 5.65 | 0.904 |
| Malpractice | 0.79 | 0.504 |
(3.7 × 1 + 5.65 × 0.904 + 0.79 × 0.504) × $33.4009 = $307.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
26100 billing questions
How does this differ from a finger joint biopsy?
This code is for an open biopsy of the carpometacarpal joint at the base of the hand. Use the finger-joint biopsy code when the sampled joint is a metacarpophalangeal or interphalangeal joint.
Is this a biopsy or a synovectomy?
Report this code when the surgeon opens the carpometacarpal joint to take a diagnostic sample of its lining. A procedure that removes lining therapeutically is a synovectomy, not a biopsy.
What documentation supports reporting the code?
The operative note should identify the carpometacarpal joint, describe the open approach, and state that joint-lining tissue was obtained for evaluation.
Does the 90-day global include related follow-up care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this handled when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can modifier 50 be used for a bilateral procedure?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
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.
2,53926070,,Explore/treat hand joint,A,,3.71,4.98,NA,4.98,,0.68,9.37,9.37,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,54026075,,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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958