CPT code 26230: Hand bone excision2026 Medicare rate & RVUs in Texas
Partial metacarpal excision removes a portion of a hand bone, commonly for a condition such as osteomyelitis requiring surgical bone removal.
CMS doesn’t publish an office rate for 26230 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 26230 covers
A hand or orthopedic surgeon removes part of a metacarpal, one of the long bones of the hand. The procedure may be performed to remove diseased bone, such as bone affected by osteomyelitis, in an operating room or another surgical setting. This code describes partial removal of the metacarpal, rather than a targeted excision or curettage of a bone cyst or benign tumor.
Select the code when the operative report supports partial excision of a metacarpal; document the specific bone, the portion removed, the indication, and the operative work. The code 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 requires documentation of 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.
Where 26230 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 | $480.16 |
| Beaumont | Unavailable | $448.92 |
| Brazoria | Unavailable | $462.36 |
| Dallas | Unavailable | $466.85 |
| Fort Worth | Unavailable | $465.18 |
| Galveston | Unavailable | $464.76 |
| Houston | Unavailable | $487.09 |
| Rest Of Texas | Unavailable | $456.44 |
How the 26230 rate is calculated
Each of 26230’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 · 26230
RVUs × geographic indexes × conversion factor
Work6.31
6.31 RVUs× 1.000 GPCI
Practice expense6.59
6.59 RVUs× 1.000 GPCI
Malpractice1.22
1.22 RVUs× 1.000 GPCI
Adjusted RVUs
14.1200
Conversion factor
$33.4009
Medicare rate
$471.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26230
26230 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26230
Hand bone excision
| 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) | 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 · 26230
Hand bone excision
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
26230 without 51 · national facility
$471.62
Hand bone excision
26230-51 · Second procedure: 50%
$235.81
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%).
26230 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26200Bone lesion removal
- 26200 is for excision or curettage of a metacarpal bone cyst or benign tumor. Use 26230 when the documented service is partial removal of the metacarpal.
- 26205Bone lesion surgery
- 26205 covers metacarpal bone cyst or benign tumor excision or curettage with bone grafting. The key distinction is the lesion-directed service and grafting, not partial metacarpal excision alone.
- 26235Finger bone surgery
- 26235 describes partial excision of a finger phalanx. Choose based on the bone treated: a metacarpal for 26230 or a phalanx for 26235.
- 26250Hand tumor resection
- 26250 is for radical resection of a metacarpal tumor. Code 26230 describes partial metacarpal excision, not radical tumor resection.
26230 billing questions
How is this different from code 26200?
Use 26230 for partial removal of a metacarpal. Code 26200 describes excision or curettage directed at a bone cyst or benign tumor in a metacarpal.
When would code 26205 be considered instead?
Code 26205 applies to excision or curettage of a metacarpal bone cyst or benign tumor with bone grafting. It is not the code for partial metacarpal removal alone.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported for bilateral work?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
When is an assistant at surgery payable?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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