No office rate
Use 26992 for drainage of a lesion within bone. Code 26990 describes drainage directed to a pelvic lesion rather than a bone lesion.
On this page
CMS RVU26D · Effective 2026-10-01
26992 Bone lesion drainage Medicare reimbursement rates in Maine
Reports operative drainage of a lesion within bone when the surgeon opens the affected site to evacuate its contents. Compare 26992 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 26992 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
No supported rate
Facility setting
$875.86–$905.85
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.
Orthopedic surgery
About 26992: Operative drainage of bone lesion
Reports operative drainage of a lesion within bone when the surgeon opens the affected site to evacuate its contents.
This service involves surgically opening a bone lesion to drain its contents. An orthopedic surgeon or another surgeon treating bone disease typically performs it in an operating room or other surgical facility. The operative report should identify the bone and lesion treated, describe the approach and drainage performed, and distinguish the target from a nearby soft-tissue collection or bursa.
Report the code when the operative work is drainage of the bone lesion, rather than diagnostic bone sampling or removal of a tumor. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 multiple-procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26992
- 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 RVU13.14 · 46%
- Practice expense (office) RVU12.28 · 43%
- Malpractice RVU2.87 · 10%
324
Medicare services in 2024 · #3935 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.
26992 compared with similar codes
Office rates for Maine, from the same CMS release.
$689.60–$723.25
Code 26991 concerns drainage of a pelvic bursa. This code is for drainage of a lesion within bone.
No office rate
Code 20245 is for open bone biopsy to obtain diagnostic tissue. Use 26992 when the operative work is drainage of the bone lesion.
Compare 26992 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
Unavailable
Facility
$875.86
Southern Maine →
Office / nonfacility
Unavailable
Facility
$905.85
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26992 billing questions
How is this different from a bone biopsy?
This code describes operative drainage of a bone lesion. A bone biopsy code is used when the service is obtaining tissue for diagnosis rather than draining the lesion.
What documentation supports reporting this code?
Document the bone and lesion treated, the operative approach, and the drainage performed. The note should make clear that the target was within bone, not a bursa or adjacent soft tissue.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
Does modifier 50 apply when lesions are treated on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of 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 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.
2,70526989,,Unlisted px hands/fingers,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70626990,,Drainage of pelvis lesion,A,,7.75,10.35,NA,10.35,,1.68,19.78,19.78,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70726991,,Drainage of pelvis bursa,A,,6.88,14.01,,6.43,,1.41,22.30,14.72,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70826992,,Drainage of bone lesion,A,,13.14,12.28,NA,12.28,,2.87,28.29,28.29,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,70927000,,Tenotomy adductor hip perq,A,,5.60,4.67,NA,4.67,,0.58,10.85,10.85,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71027001,,Tenotomy adductor hip open,A,,6.96,6.96,NA,6.96,,1.47,15.39,15.39,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71127003,,Tnot adductr subq opn neurct,A,,7.61,7.87,NA,7.87,,1.63,17.11,17.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00