This code includes the grafting service for metacarpal lesion treatment; 26200 describes lesion removal or curettage without that grafting service.
On this page
CMS RVU26D · Effective 2026-10-01
26200 Bone lesion removal Medicare reimbursement rates in Kansas
Reports excision or curettage of a cyst or benign tumor in a metacarpal when the surgeon treats the lesion without the grafting service. Compare 26200 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 26200 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
$391.24
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 26200: Metacarpal bone lesion excision
Reports excision or curettage of a cyst or benign tumor in a metacarpal when the surgeon treats the lesion without the grafting service.
A hand or orthopedic surgeon uses this service to remove or curette a bone cyst or benign tumor in a metacarpal. The operation may involve opening the affected bone and removing the lesion; the resulting specimen may be submitted for pathologic examination. These cases are commonly performed in a hospital or ambulatory surgery setting when a metacarpal lesion requires operative treatment.
Select the code based on the treated bone and the procedure performed. Document the metacarpal involved, the lesion and its location, the removal or curettage, and whether grafting was performed. This code has a 90-day global period, including 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26200
- 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
- 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 RVU5.51 · 43%
- Practice expense (office) RVU6.26 · 49%
- Malpractice RVU1.08 · 8%
179
Medicare services in 2024 · #4426 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.
26200 compared with similar codes
Office rates for Kansas, from the same CMS release.
Use 26210 for a bone cyst or benign tumor in a finger phalanx. Code 26200 is for a metacarpal.
26230 describes partial excision of a metacarpal, rather than removal or curettage directed at a bone cyst or benign tumor.
Compare 26200 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
$391.24
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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 26200 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,562
- Code
- 26200
- Physician work
- 5.51
- Practice expense
- 6.26
- Malpractice
- 1.08
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.51 | × 1.000 | 5.5100 |
| Practice expense | 6.26 | × 0.904 | 5.6590 |
| Malpractice | 1.08 | × 0.504 | 0.5443 |
| Total RVUs | 11.7134 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$391.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.51 | 1 |
| Practice expense | 6.26 | 0.904 |
| Malpractice | 1.08 | 0.504 |
(5.51 × 1 + 6.26 × 0.904 + 1.08 × 0.504) × $33.4009 = $391.24
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.
26200 billing questions
When is 26200 used instead of 26205?
Use 26200 for metacarpal lesion removal or curettage without the grafting service. When bone grafting is part of the lesion treatment, consider 26205.
Can 26200 be reported for a finger phalanx lesion?
No. This code is for a metacarpal; lesion treatment in a finger phalanx is represented by the related phalanx codes, such as 26210 or 26215.
Is modifier 50 appropriate for lesions in both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 26200?
Document the metacarpal treated, the lesion and its location, and the operative work removing or curetting it. Note whether grafting was performed to support selection between lesion-treatment codes.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. The code also carries a 90-day global period for related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
