Billing code 26990: Abscess drainageMedicare rate & RVUs in Utah
Operative drainage of a deep abscess or hematoma in the pelvis or hip region, rather than an infected bursa, bone lesion, or joint space.
CMS doesn’t publish an office rate for 26990 in Utah.
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 26990 covers
billing code 26990 describes operative drainage of a deep soft-tissue abscess or hematoma in the pelvis or around the hip. An orthopedic or general surgeon typically performs the procedure in an operating room, where the collection can be reached and drained through a surgical incision. The code is for the deep collection, not drainage of an infected bursa, bone infection, or the hip joint itself.
Select the code based on the documented site and tissue involved, along with the operative findings and work performed. The report should support a deep abscess or hematoma and describe its location and drainage. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.
26990 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $634.20 |
How the 26990 rate is calculated
Each of 26990’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 · 26990
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.75Practice expense 10.35Malpractice 1.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26990
26990 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26990
Abscess drainage
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 26990
Abscess drainage
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
26990 without 51 · national facility
$660.67
Abscess drainage
26990-51 · Second procedure: 50%
$330.34
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%).
26990 compared with similar codes
Compare codes
26990 vs 26991 vs 26992 vs 27030 vs 10061: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26991Bursa drainage
- 26991 is selected when the drainage targets an infected bursa; 26990 describes a deep abscess or hematoma.
- 26992Bone lesion drainage
- 26992 is for drainage directed at a bone lesion. Use 26990 when the operative target is a deep abscess or hematoma instead.
- 27030Hip drainage
- 27030 describes drainage through the hip joint. Use 26990 for a deep collection in the surrounding pelvic or hip region, not within the joint.
- 10061Abscess drainage
- 10061 applies to complicated or multiple superficial cutaneous abscesses; 26990 is for a deep pelvic or hip-region abscess or hematoma.
26990 billing questions
How is 26990 distinguished from 26991 or 26992?
Use 26990 for a deep abscess or hematoma. The neighboring codes describe drainage directed at an infected bursa or a bone lesion, respectively.
Is 26990 appropriate for a hip joint infection?
No. 26990 concerns a deep collection in the pelvis or hip region, not drainage within the joint. Hip-joint drainage is represented by 27030.
Does modifier 50 apply when both sides are involved?
No. CMS identifies bilateral adjustment as inappropriate for 26990; do not append modifier 50.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid for 26990?
CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are not permitted for this code.
How does the multiple-procedure reduction work?
When 26990 is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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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