Surgical incision and drainage of a single palmar bursa — either the radial (thenar) or ulnar (hypothenar) bursa — to evacuate infected or inflamed fluid from the palm.

Verified May 8, 2026 · 7 sources ↓

Medicare: $404.48
Total RVUs: 12.11
Global, days: 90
Region: Hand

Drawn from AAPCEatonhandMdclarityAMACMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Identify which bursa was drained — radial (thenar) or ulnar (hypothenar) — by name in the operative note
Describe the incision location, depth of dissection, and method of drainage (open incision vs. other approach)
Document pre-operative clinical findings supporting the need for drainage, including signs of infection or bursitis
Confirm that only one bursa was drained; if both were addressed, documentation must support upgrading to 26030
Record any cultures, irrigation, wound closure technique, and post-operative instructions in the operative report

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 26025 covers open drainage of one palmar bursa. The palm contains two main bursae: the thenar (radial) bursa, which covers the flexor pollicis longus tendon, and the hypothenar (ulnar) bursa, which covers the flexor tendons to the index, middle, and ring fingers. Bill 26025 when only one of these is drained. If both are drained in the same session, step up to 26030.

The 90-day global period means any routine follow-up wound care, dressing changes, and postoperative checks within 90 days are bundled — no separate billing. An E/M billed same-day as 26025 requires modifier 25 if it reflects a significantly separate, identifiable decision-making visit. If the surgeon decides intraoperatively to proceed with a more complex or additional procedure, modifier 22 applies only when operative documentation thoroughly supports the substantially increased work.

Bilateral palmar bursa drainage is an edge case. Medicare has denied paired 26025-LT and 26025-RT claims as frequency errors. The cleaner path when both hands are treated in the same session is to verify payer-specific bilateral reporting requirements before submitting — some payers accept modifier 50, others want separate line items with LT and RT. Confirm before you bill.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	4.95
Practice expense RVU	6.17
Malpractice RVU	0.99
Total RVU	12.11
Medicare national rate	$404.48
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$404.48
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 26025 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Bilateral billing of 26025-LT and 26025-RT denied by Medicare as exceeding frequency limits — verify payer bilateral policy before submitting
Upcoding flag when 26025 is billed but documentation does not clearly identify which single bursa (thenar vs. hypothenar) was drained
Bundling denial when a same-day E/M is billed without modifier 25 and the chart does not demonstrate a separately identifiable evaluation
Global period denial when post-operative visits are billed within the 90-day window without modifier 24 documenting an unrelated reason

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 26025 and 26030?

26025 is for drainage of a single palmar bursa (either thenar or hypothenar). 26030 applies when more than one bursa is drained in the same operative session. The distinction is anatomical and count-based — your operative note must name the bursa(e) drained to support whichever code you bill.

02Can 26025 be billed bilaterally if both hands are treated the same day?

Technically yes, but Medicare has denied paired 26025-LT/RT claims as frequency errors. Check individual payer policies before submitting. Some accept modifier 50 on a single line; others require separate lines with LT and RT. Do not assume a standard bilateral rule applies without verifying.

03Does 26025 carry a global period, and what does that mean for post-op billing?

Yes — 90-day global. Routine post-op wound checks, dressing changes, and stitch removal within 90 days are bundled and cannot be billed separately. Use modifier 24 only for E/M visits clearly unrelated to the palmar bursa drainage.

04When should modifier 22 be appended to 26025?

Only when the operative note documents substantially increased work beyond the typical procedure — such as dense scarring, prior surgical changes, or unusually extensive infection requiring prolonged dissection. Modifier 22 without strong narrative documentation supporting the extra work is a common audit trigger.

05Can an E/M service be billed on the same day as 26025?

Yes, with modifier 25 on the E/M code. The visit must be documented as a significantly and separately identifiable evaluation — not just the pre-procedure assessment for the drainage itself. Different diagnoses are not required, but the chart must show distinct decision-making beyond what the drainage procedure already encompasses.

06Is 26025 appropriate for a thenar space infection versus a true bursal infection?

These are anatomically distinct. Thenar space infections involve the deep fascial compartment and may warrant different coding (e.g., 26034 for bone or deep space). 26025 is specific to the palmar bursa — radial or ulnar. Operative documentation should confirm the structure drained to avoid a miscoding flag.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific bursa drained (thenar/radial or hypothenar/ulnar), the incision approach, depth of dissection, drainage findings, wound irrigation details, and closure technique directly from the surgeon's dictation. This prevents the most common audit flag: operative notes that fail to identify which single bursa was treated — the key distinction separating 26025 from 26030.

See how Mira captures CPT 26025 documentation