No office rate
Both address a metacarpal bone lesion, but 26205 includes autologous graft placement and harvest; 26200 is used when grafting is not performed.
On this page
CMS RVU26D · Effective 2026-10-01
26205 Bone lesion surgery Medicare reimbursement rates in Michigan
Reports curettage or excision of a benign cyst or tumor in a metacarpal when the resulting bone defect is filled with an autologous graft. Compare 26205 office and facility rates across CMS payment localities in Michigan.
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 26205 in Michigan?
Michigan 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
$560.33–$604.53
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 26205: Metacarpal lesion curettage with bone graft
Reports curettage or excision of a benign cyst or tumor in a metacarpal when the resulting bone defect is filled with an autologous graft.
A hand surgeon treats a benign bone cyst or tumor in a metacarpal by removing or curetting the lesion and placing the patient’s own bone graft in the resulting defect. The graft is harvested as part of the service. This procedure is typically performed in an operating room, with the operative report identifying the metacarpal and describing lesion removal and graft placement.
Select this code when the treated bone is a metacarpal and an autologous graft is used; the no-graft code 26200 is the nearby choice when grafting is not performed. Document the lesion, its site, the removal technique, and graft use and harvest. Medicare 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 26205
- 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 RVU7.73 · 45%
- Practice expense (office) RVU7.88 · 46%
- Malpractice RVU1.64 · 10%
16
Medicare services in 2024 · #6028 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.
26205 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This code is for a metacarpal. Code 26215 is the corresponding grafted lesion procedure for a finger phalanx.
No office rate
Code 26230 describes partial removal of metacarpal bone. Choose 26205 when the service is lesion curettage or excision with an autologous graft.
Compare 26205 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
Detroit →
Office / nonfacility
Unavailable
Facility
$604.53
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$560.33
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26205 billing questions
When should 26205 be chosen over 26200?
Use 26205 for a metacarpal lesion when an autologous bone graft is placed after lesion removal. Code 26200 is the nearby option when no graft is used.
Can the bone graft harvest be billed separately?
The graft harvest is included in this service. The operative documentation should establish that the graft was autologous and placed in the metacarpal defect.
Does modifier 50 apply if lesions are treated on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How does the 90-day global period affect follow-up visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical package.
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; 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.
2,56026180,,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
2,56226200,,Remove hand bone lesion,A,,5.51,6.26,NA,6.26,,1.08,12.85,12.85,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56326205,,Remove/graft bone lesion,A,,7.73,7.88,NA,7.88,,1.64,17.25,17.25,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56426210,,Removal of finger lesion,A,,5.19,6.64,NA,6.64,,1.00,12.83,12.83,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56526215,,Remove/graft finger lesion,A,,7.09,7.67,NA,7.67,,1.50,16.26,16.26,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56626230,,Partial removal of hand bone,A,,6.31,6.59,NA,6.59,,1.22,14.12,14.12,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00