No office rate
This code targets a lesion arising from a tendon sheath or joint capsule. 26111 is for a subcutaneous hand lesion meeting its size criterion.
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CMS RVU26D · Effective 2026-10-01
26160 Tendon sheath excision Medicare reimbursement rates in Kansas
Reports surgical removal of a lesion arising from a hand or finger tendon sheath or joint capsule, such as a ganglion or cyst. Compare 26160 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 26160 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
$596.87
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$281.34
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 26160: Hand tendon sheath lesion excision
Reports surgical removal of a lesion arising from a hand or finger tendon sheath or joint capsule, such as a ganglion or cyst.
A hand surgeon removes a lesion attached to a tendon sheath or joint capsule in the hand or finger. A common example is a ganglion arising from a finger tendon sheath; cystic or other localized lesions may also be treated. The service is typically performed by an orthopedic or plastic surgeon in an operating room or ambulatory surgery setting, with the lesion separated from the involved sheath or capsule and removed.
Select this code when the operative findings identify the lesion as arising from the tendon sheath or joint capsule, rather than as a separate superficial or deep soft-tissue mass. Document the involved structure, location, lesion, and excision. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26160
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.48 · 18%
- Practice expense (office) RVU15.55 · 79%
- Malpractice RVU0.66 · 3%
25.6K
Medicare services in 2024 · #1038 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.
26160 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Use this code for a sheath- or capsule-based lesion. 26113 addresses a deep hand tumor meeting its size criterion.
No office rate
26145 involves excision of a tendon in the palm or finger. This code removes a lesion arising from the tendon sheath or joint capsule, not the tendon itself.
Compare 26160 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
$596.87
Facility
$281.34
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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 26160 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,558
- Code
- 26160
- Physician work
- 3.48
- Practice expense
- 15.55
- Malpractice
- 0.66
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.48 | × 1.000 | 3.4800 |
| Practice expense | 15.55 | × 0.904 | 14.0572 |
| Malpractice | 0.66 | × 0.504 | 0.3326 |
| Total RVUs | 17.8698 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$596.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.48 | 1 |
| Practice expense | 15.55 | 0.904 |
| Malpractice | 0.66 | 0.504 |
(3.48 × 1 + 15.55 × 0.904 + 0.66 × 0.504) × $33.4009 = $596.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.48 | 1 |
| Practice expense | 5.1 | 0.904 |
| Malpractice | 0.66 | 0.504 |
(3.48 × 1 + 5.1 × 0.904 + 0.66 × 0.504) × $33.4009 = $281.34
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.
26160 billing questions
How is this different from excision of a hand soft-tissue mass?
Use this code when the lesion arises from a tendon sheath or joint capsule. Codes for hand masses are selected according to the mass's tissue plane and, for some codes, size.
Can a ganglion from a finger tendon sheath be reported with this code?
Yes, when the surgeon excises a ganglion arising from the tendon sheath. The operative note should identify the origin and the structure from which it was removed.
Should modifier 50 be used for lesions on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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 multiple procedure reduction. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
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.
2,55526135,,Revise finger joint each,A,,6.95,7.28,NA,7.28,,1.32,15.55,15.55,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,55626140,,Revise finger joint each,A,,6.18,7.02,NA,7.02,,1.19,14.39,14.39,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,55726145,,Tendon excision palm/finger,A,,6.33,7.04,NA,7.04,,1.21,14.58,14.58,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,55826160,,Remove tendon sheath lesion,A,,3.48,15.55,,5.10,,0.66,19.69,9.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,55926170,,Removal of palm tendon each,A,,4.79,6.02,NA,6.02,,0.92,11.73,11.73,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56026180,,Removal of finger tendon,A,,5.22,6.69,NA,6.69,,1.00,12.91,12.91,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56126185,,Remove finger bone,A,,6.36,8.69,NA,8.69,,1.34,16.39,16.39,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,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