Billing code 26100: Joint biopsyMedicare rate & RVUs in Ohio
Reports an open biopsy of the carpometacarpal joint lining when a hand surgeon obtains tissue to investigate a joint disorder.
CMS doesn’t publish an office rate for 26100 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 26100 covers
A hand surgeon opens the carpometacarpal joint at the base of the hand and takes a sample of its lining for diagnostic evaluation. The procedure may be performed in a hospital operating room or another surgical setting when a tissue sample is needed to investigate an abnormal joint process. The service is a biopsy, not removal of the joint lining as treatment and not a biopsy of a finger joint.
Report the code for the carpometacarpal joint and document the specific site, the open joint approach, and that lining tissue was sampled. This code has a 90-day global period, which includes 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 at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
26100 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $322.48 |
How the 26100 rate is calculated
Each of 26100’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 26100
RVUs × geographic indexes × conversion factor
Work3.70
3.70 RVUs× 1.000 GPCI
Practice expense5.65
5.65 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
10.1400
Conversion factor
$33.4009
Medicare rate
$338.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26100
26100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26100
Joint biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26100
Joint biopsy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
26100 without 50 · national facility
$338.69
Joint biopsy
26100-50 · Bilateral: 150%
$508.04
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
26100 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26105Joint biopsy
- Use 26105 for biopsy of a metacarpophalangeal joint lining. Code 26100 is for the carpometacarpal joint at the base of the hand.
- 26110Joint biopsy
- Use 26110 for biopsy of an interphalangeal joint lining. Code 26100 identifies the carpometacarpal joint, not a finger joint.
- 26130Wrist synovectomy
- Code 26100 describes diagnostic sampling of the carpometacarpal joint lining. Code 26130 describes therapeutic removal of joint lining by synovectomy.
26100 billing questions
How does this differ from a finger joint biopsy?
This code is for an open biopsy of the carpometacarpal joint at the base of the hand. Use the finger-joint biopsy code when the sampled joint is a metacarpophalangeal or interphalangeal joint.
Is this a biopsy or a synovectomy?
Report this code when the surgeon opens the carpometacarpal joint to take a diagnostic sample of its lining. A procedure that removes lining therapeutically is a synovectomy, not a biopsy.
What documentation supports reporting the code?
The operative note should identify the carpometacarpal joint, describe the open approach, and state that joint-lining tissue was obtained for evaluation.
Does the 90-day global include related follow-up care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this handled when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can modifier 50 be used for a bilateral procedure?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 26100 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →