Billing code 26991: Bursa drainageMedicare rate & RVUs in Utah
Surgical drainage of an infected bursa in the pelvis or hip region, reported when the operative target is the bursa rather than superficial tissue or bone.
Medicare pays $711.96 for 26991 in the office in Utah (Utah). Which amount applies depends on the service address.
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 26991 covers
This service involves surgically opening and draining an infected bursa in the pelvis or hip region. It is typically performed by an orthopedic surgeon in a hospital operating room when infection requires operative drainage. The operative report should identify the involved bursa and describe the drainage performed; a superficial collection or a bone lesion has a different target.
Report the code for drainage directed at the infected bursa, not merely because a collection is near the hip. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. 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 for this code. 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.
26991 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $711.96 | $473.97 |
How the 26991 rate is calculated
Each of 26991’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 · 26991
RVUs × geographic indexes × conversion factor
Work6.88
6.88 RVUs× 1.000 GPCI
Practice expense14.01
14.01 RVUs× 1.000 GPCI
Malpractice1.41
1.41 RVUs× 1.000 GPCI
Adjusted RVUs
22.3000
Conversion factor
$33.4009
Medicare rate
$744.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26991
26991 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26991
Bursa 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) | 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 · 26991
Bursa 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
26991 without 51 · national office
$744.84
Bursa drainage
26991-51 · Second procedure: 50%
$372.42
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%).
26991 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26990Abscess drainage
- Choose 26990 for a superficial collection in the pelvis or hip area. This code is for drainage targeting an infected bursa.
- 26992Bone lesion drainage
- Choose 26992 when the drainage targets a bone lesion. This code targets an infected bursa.
- 27030Hip drainage
- 27030 addresses operative drainage of the hip joint. This code is for an infected bursa in the pelvis or hip region.
26991 billing questions
How is this distinguished from drainage of a superficial pelvic or hip-area collection?
Use this code when the operative target is an infected bursa. A superficial collection is a different target and is represented by 26990.
When would drainage of a bone lesion be reported instead?
Code 26992 concerns drainage directed at a bone lesion. The operative documentation should make clear whether the target is the bursa or bone.
Does the 90-day global period include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral drainage?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
When is assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure 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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