Billing code 26118: Hand tumor resectionMedicare rate & RVUs in Texas
Reports radical resection of a hand tumor measuring 3 cm or larger when the operative approach involves more than routine local excision.
CMS doesn’t publish an office rate for 26118 in Texas.
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 26118 covers
A hand surgeon, commonly an orthopedic hand surgeon or surgical oncologist, uses this code for radical removal of a hand tumor measuring at least 3 cm. The procedure is generally performed in an operating room, with the tumor and surrounding tissue addressed as part of the documented radical resection. The operative report should identify the hand site, tumor size, and extent of removal.
Choose this code when both the radical resection and size threshold are supported; tumor size alone does not distinguish it from a routine excision. Code 26117 describes the corresponding radical resection for a tumor under 3 cm. This major surgery 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; 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.
Where 26118 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $986.73 |
| Beaumont | Unavailable | $931.57 |
| Brazoria | Unavailable | $952.90 |
| Dallas | Unavailable | $962.93 |
| Fort Worth | Unavailable | $960.25 |
| Galveston | Unavailable | $958.35 |
| Houston | Unavailable | $1,011.61 |
| Rest Of Texas | Unavailable | $944.42 |
How the 26118 rate is calculated
Each of 26118’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 · 26118
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.44Practice expense 11.81Malpractice 2.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26118
26118 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26118
Hand tumor resection
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 26118
Hand tumor resection
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 51 · payment effect
With and without the modifier
26118 without 51 · national facility
$973.97
Hand tumor resection
26118-51 · Second procedure: 50%
$486.99
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26118 compared with similar codes
Compare codes
26118 vs 26117 vs 26113 vs 26111: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26117Hand tumor resection
- This is the closest sibling code: 26117 is for radical resection of a hand tumor under 3 cm; 26118 is for a tumor measuring 3 cm or larger.
- 26113Hand tumor excision
- 26113 describes excision of a deep hand tumor measuring 1.5 cm or larger. Choose 26118 only when the operative report supports radical resection and the tumor is at least 3 cm.
- 26111Hand mass excision
- 26111 is for excision of a subcutaneous hand lesion measuring 1.5 cm or larger. It is not the radical resection code for a tumor at least 3 cm.
26118 billing questions
How does 26118 differ from 26117?
Both describe radical resection of a hand tumor. Use 26118 for a tumor measuring 3 cm or larger and 26117 for one under 3 cm.
Can tumor size alone support 26118?
No. The record should support a radical resection, as well as a tumor size of at least 3 cm; a large tumor removed by routine excision does not establish this service.
When is 26113 more appropriate?
26113 describes excision of a deep hand tumor measuring 1.5 cm or larger. Use 26118 when the documented procedure is a radical resection and the tumor is at least 3 cm.
Is modifier 50 appropriate for tumors on both hands?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. 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 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
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