Use 26111 for a subcutaneous hand or finger lesion measuring 1.5 cm or larger; 26115 is for one under 1.5 cm.
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CMS RVU26D · Effective 2026-10-01
26115 Hand mass excision Medicare reimbursement rates in Maine
Reports surgical removal of a subcutaneous soft-tissue lesion of the hand or finger when the excised lesion measures less than 1.5 cm. Compare 26115 office and facility rates across CMS payment localities in Maine.
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 26115 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$543.98–$575.04
2 of 2 localities have a supported rate.
Facility setting
$298.46–$310.57
2 of 2 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.
Hand surgery
About 26115: Subcutaneous hand mass excision under 1.5 cm
Reports surgical removal of a subcutaneous soft-tissue lesion of the hand or finger when the excised lesion measures less than 1.5 cm.
A surgeon removes a small soft-tissue mass located beneath the skin of the hand or a finger. The code fits a superficial lesion, such as a discrete subcutaneous nodule, rather than a mass extending into deeper structures. Hand and orthopedic surgeons commonly perform the procedure in an operating room or ambulatory surgery setting; the operative report should identify the site, tissue depth, lesion size, and extent of removal.
Select this code when the lesion is subcutaneous and under 1.5 cm; a lesion at least 1.5 cm or one involving deeper tissue belongs to a different code in the excision family. CMS assigns 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 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, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26115
- 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 RVU3.86 · 22%
- Practice expense (office) RVU13.00 · 74%
- Malpractice RVU0.75 · 4%
5.5K
Medicare services in 2024 · #1809 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.
26115 compared with similar codes
Office rates for Maine, from the same CMS release.
Use 26116 when the lesion is deep rather than subcutaneous, even if it is under 1.5 cm.
Use 26160 for a lesion of a tendon sheath or joint capsule. This code describes a subcutaneous soft-tissue lesion.
26117 describes radical resection of a hand tumor, not routine excision of a small subcutaneous mass.
Compare 26115 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$543.98
Facility
$298.46
Southern Maine →
Office / nonfacility
$575.04
Facility
$310.57
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26115 billing questions
How does this code differ from 26111?
Both describe excision of a subcutaneous hand or finger lesion. Use 26115 when the lesion is under 1.5 cm and 26111 when it is 1.5 cm or larger.
When is 26116 a better fit?
26116 is for a lesion in deeper soft tissue measuring under 1.5 cm. The operative report should support whether the mass was subcutaneous or deep.
Can the related postoperative visits be billed separately?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit. Care unrelated to the operation is outside that stated global package.
Should modifier 50 be appended for lesions on both hands?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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.
