No office rate
Use 26215 when an autograft is placed after treatment of the phalanx lesion; 26210 represents the corresponding procedure without grafting.
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CMS RVU26D · Effective 2026-10-01
26215 Finger bone lesion Medicare reimbursement rates in Virginia
Reports removal or curettage of a benign lesion in a finger phalanx when the resulting bone cavity is filled with the patient's own bone graft. Compare 26215 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26215 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$524.01–$607.15
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Hand surgery
About 26215: Finger phalanx lesion excision with graft
Reports removal or curettage of a benign lesion in a finger phalanx when the resulting bone cavity is filled with the patient's own bone graft.
A hand or orthopedic surgeon uses this service to remove or curette a bone cyst or benign tumor in a finger phalanx and fill the defect with the patient's own bone graft. It fits treatment of a lesion within the phalanx, rather than a lesion of a metacarpal or a procedure that removes part of the bone for another reason. The graft harvest is included in the service. These operations are generally performed in a surgical setting; Medicare recorded facility services for this code in 2024.
Select the code when the operative report identifies the affected phalanx, the benign lesion and its removal or curettage, and placement of an autograft. 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 one 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. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 26215
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.09 · 44%
- Practice expense (office) RVU7.67 · 47%
- Malpractice RVU1.50 · 9%
35
Medicare services in 2024 · #5566 by national volume
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.
26215 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
This is a related grafted bone-lesion procedure at a different hand-bone site. Code 26215 is specific to a finger phalanx.
No office rate
This code describes partial removal of finger bone. Choose 26215 for treatment of a benign lesion with autograft, not partial bone excision as the operative service.
No office rate
This code describes resection of a proximal finger tumor. Code 26215 describes removal or curettage of a benign phalanx lesion with autograft.
Compare 26215 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$607.15
Virginia →
Office / nonfacility
Unavailable
Facility
$524.01
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26215 billing questions
When is 26215 reported instead of 26210?
Report 26215 when the surgeon fills the defect with the patient's own bone graft after treating the phalanx lesion. Code 26210 describes the corresponding lesion procedure without the graft.
Can the bone graft harvest be billed separately?
No. The graft harvest is included in this service.
What documentation supports 26215?
The operative report should identify the finger phalanx and benign lesion, describe its excision or curettage, and document placement of an autograft.
Should modifier 50 be used for lesions on both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,56226200,,Remove hand bone lesion,A,,5.51,6.26,NA,6.26,,1.08,12.85,12.85,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56326205,,Remove/graft bone lesion,A,,7.73,7.88,NA,7.88,,1.64,17.25,17.25,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56426210,,Removal of finger lesion,A,,5.19,6.64,NA,6.64,,1.00,12.83,12.83,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56526215,,Remove/graft finger lesion,A,,7.09,7.67,NA,7.67,,1.50,16.26,16.26,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56626230,,Partial removal of hand bone,A,,6.31,6.59,NA,6.59,,1.22,14.12,14.12,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56726235,,Partial removal finger bone,A,,6.17,6.55,NA,6.55,,1.19,13.91,13.91,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,56826236,,Partial removal finger bone,A,,5.32,6.28,NA,6.28,,1.04,12.64,12.64,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00