Surgical drainage of multiple palmar bursas in a single hand through open incision to evacuate fluid from more than one bursal sac.

Verified May 8, 2026 · 6 sources ↓

Medicare: $465.94
Total RVUs: 13.95
Global, days: 90
Region: Hand

Drawn from CMSFastrvuAbosAAPCEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Confirm and document the number of distinct palmar bursas drained — must be more than one to support 26030 over 26025.
Identify which bursas were drained by name (radial bursa, ulnar bursa) and confirm both are in the same hand.
Document clinical indications: persistent swelling, failed antibiotic therapy, infection, or functional impairment.
Record the surgical approach, incision location(s), volume and character of fluid drained, and irrigation performed.
Specify laterality (right hand or left hand) in the operative note and on the claim.
Note anesthesia type and surgical setting (office, ASC, or HOPD) to support place-of-service coding.

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 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26030 covers open incision and drainage of multiple palmar bursas — use it when the operative note documents more than one bursal sac drained in the same palm. The dividing line between 26025 and 26030 is bursa count: 26025 is for a single palmar bursa; 26030 applies when two or more are drained. There are two distinct palmar bursas (radial and ulnar), so bilateral single-bursa drainage on both hands does not automatically qualify for 26030 — the multiple bursas must be in the same hand.

The 90-day global period applies. All routine post-op palm care, dressing changes, and wound checks within that window are included. A separate E/M in the global period requires modifier 24 (unrelated) or 79 (unrelated return procedure). The code carries a work RVU of 6.09 and a non-facility total RVU of 13.95 under the 2026 CMS Physician Fee Schedule.

Bilateral drainage documented as one bursa per hand should be coded 26025-LT and 26025-RT — not 26030 with modifier 50. Medicare has denied claims coded that way for frequency errors. If the operative setting is an ASC or HOPD, confirm the correct place-of-service code, as facility payment rates differ substantially from the non-facility rate.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.09
Practice expense RVU	6.67
Malpractice RVU	1.19
Total RVU	13.95
Medicare national rate	$465.94
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	$465.94
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 26030 get rejected.

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

Upcoding from 26025: insufficient documentation that more than one bursa was drained — note only references 'palmar bursa' generically.
Bilateral single-bursa claims coded as 26030 with modifier 50 denied for frequency; each hand with one bursa drained should be 26025-LT and 26025-RT.
Missing laterality modifier causes claim rejection or bundling errors on same-session hand procedures.
Global period conflict: E/M billed within the 90-day post-op window without modifier 24 to establish the visit as unrelated.
Place-of-service mismatch: procedure performed in ASC or HOPD but billed with non-facility RVU, or vice versa.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between CPT 26025 and CPT 26030?

26025 is for drainage of a single palmar bursa. 26030 applies when two or more palmar bursas are drained in the same hand. Bursa count in the operative note is the deciding factor.

02Can I bill 26030 with modifier 50 for bilateral palmar bursa drainage?

Not if only one bursa per hand was drained. Bill 26025-LT and 26025-RT instead. Using 26030-50 in that scenario has generated Medicare denials for excessive frequency.

03What is the global period for CPT 26030?

90 days. Routine follow-up, wound checks, and dressing changes within that window are bundled. Use modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures during the global period.

04Which ICD-10 codes are commonly linked to CPT 26030?

M71.04 (bursitis of hand), M71.042 (bursitis, right hand), M71.09 (other infective bursitis), and M71.89 (other bursopathies) are commonly paired depending on whether the etiology is infectious or inflammatory.

05Does the place of service affect reimbursement for CPT 26030?

Yes. The non-facility rate reflects the full 13.95 total RVU. When performed in an ASC or HOPD, the physician bills the facility rate and the facility bills separately. Confirm POS code matches the actual setting before submitting.

06When is modifier 22 appropriate for CPT 26030?

Use modifier 22 when the procedure required substantially more work than typical — for example, dense adhesions, significantly distorted anatomy from prior infection, or extensive irrigation of multiple compartments. Document the added complexity explicitly in the operative note; without that, expect payer pushback.

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 bursa count, laterality, and character of each drained sac directly from dictation — distinguishing 'radial and ulnar bursas of the right palm' from a single-bursa drainage that would support only 26025. That specificity prevents the most common audit flag on 26030: an operative note that says 'palmar bursa' without confirming multiple structures were addressed.

See how Mira captures CPT 26030 documentation