Surgical opening, exploration, and treatment of the carpometacarpal (CMC) joint of the hand, including drainage or removal of a foreign or loose body.

Verified May 8, 2026 · 6 sources ↓

Medicare: $312.97
Total RVUs: 9.37
Global, days: 90
Region: Hand

Drawn from CMSAAPCMdclarityEatonhandNIH

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the joint operated on — carpometacarpal joint, and which ray (e.g., thumb CMC vs. index CMC)
State the surgical indication explicitly: infection, foreign body, loose body, or combination
Describe intraoperative findings, including appearance of synovium, presence of purulence, and any material removed
Document volume and character of fluid drained, or describe the foreign/loose body removed
Record the irrigation and closure technique used
Confirm open (not arthroscopic) approach in the operative note — code selection depends on this distinction

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26070 covers open arthrotomy of the carpometacarpal joint performed for infection, exploration, drainage, or removal of a foreign or loose body. The surgeon incises down to the CMC joint, opens the joint capsule, inspects the joint space, and removes any infectious material, loose bodies, or foreign material before irrigating and closing. This is not an arthroscopic code — it requires an open incision.

The 90-day global period means all routine postoperative care through day 90 is bundled. If the same surgeon treats an unrelated condition during that window, append modifier 79. A return to the OR for a related complication — such as persistent infection requiring repeat washout — uses modifier 78.

Site of service matters here. HOPD and ASC reimbursement differ substantially (see the Site of Service comparison table on this page). Plastic and reconstructive surgery leads in utilization, but hand surgeons and orthopedic surgeons also bill this code frequently. Document the specific joint involved, the indication (infection vs. foreign body vs. loose body), findings at arthrotomy, and what was removed or drained — auditors need all four.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.71
Practice expense RVU	4.98
Malpractice RVU	0.68
Total RVU	9.37
Medicare national rate	$312.97
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	$312.97
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 26070 get rejected.

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

Operative note says 'explored and drained' without specifying the CMC joint or laterality, causing a code-to-documentation mismatch
Missing or unsupported diagnosis — ICD-10 must align with the stated indication (e.g., infectious arthritis, foreign body in hand) or payers reject on medical necessity
Bilateral procedure billed without modifier 50 or separate RT/LT line items, triggering a duplicate-service edit
Global period conflict — a related E/M or procedure billed within 90 days without modifier 24, 78, or 79 as appropriate
Facility claim submitted as ASC when the procedure was performed in a HOPD, or vice versa, causing a site-of-service payment mismatch

Frequently asked questions

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

01Does 26070 cover arthroscopic CMC joint surgery?

No. 26070 is an open arthrotomy code. Arthroscopic procedures on the hand joints use separate codes. If you performed an open approach, 26070 is correct; if arthroscopic, verify the appropriate arthroscopy code applies.

02Can I bill 26070 for both hands in the same session?

Yes. Append modifier 50 for a bilateral procedure billed on a single line, or use LT and RT on separate lines — confirm which format your payer requires before submitting.

03What ICD-10 codes typically support 26070?

Infectious arthritis of the wrist/hand joints (M00.x, M01.x), foreign body in the hand (T18.x or S60.x), and intra-articular loose body codes are the primary drivers. The diagnosis must match the documented indication in the operative note.

04If a repeat washout is needed for persistent infection after the initial procedure, how do I bill?

Use modifier 78 — unplanned return to the OR for a complication related to the original procedure. This opens a new global period. Do not use modifier 79, which is reserved for unrelated procedures during the postoperative period.

05Is an E/M visit on the same day as 26070 billable?

Only if it represents a separately identifiable service beyond the surgical decision-making. Append modifier 25 to the E/M code. Many payers scrutinize same-day E/M with surgical codes closely, so document distinct medical decision-making in the office note.

06How does the 90-day global period affect billing for post-op complications?

Routine follow-up, dressing changes, and suture removal within 90 days are bundled — bill nothing separately. A new unrelated problem needs modifier 24 on the E/M. A return to the OR for a related complication uses modifier 78; an unrelated surgical problem uses modifier 79.

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 joint name (carpometacarpal), the specific ray involved, the operative indication, intraoperative findings, description of material drained or removed, and the irrigation and closure method — all from dictation. That eliminates the most common audit flag for 26070: an operative note that documents a hand 'exploration' without anchoring it to the CMC joint or specifying what was found and removed.

See how Mira captures CPT 26070 documentation