Excision or curettage of a bone cyst or benign tumor from the proximal, middle, or distal phalanx of a finger, with incision and removal at the bone level.

Verified May 8, 2026 · 6 sources ↓

Medicare: $428.53
Total RVUs: 12.83
Global, days: 90
Region: Hand

Drawn from CMSAAPCCgsmedicareFindacode

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 exact phalanx affected: proximal, middle, or distal — vague location is an audit flag.
Confirm the lesion originates at the bone level (phalanx), not the tendon sheath or overlying soft tissue.
Document whether a bone graft was placed; grafting tips the code to 26215 and must be explicitly noted or absent.
Record the finger and hand (laterality) involved for LT/RT modifier support.
Include pre-operative imaging (X-ray, MRI, or CT) confirming a bone cyst or benign osseous tumor.
Pathology or intraoperative findings should corroborate the benign nature of the lesion.

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 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26210 covers surgical removal or curettage of a bone cyst or benign tumor arising from the proximal, middle, or distal phalanx of a finger. The surgeon incises the skin overlying the affected phalanx, exposes the lesion, and either excises it en bloc or curettes it from the medullary or cortical bone. If the resulting void requires structural support, a bone graft may be placed before closure — but grafting does not automatically move the claim to 26215, which is the separately listed code for excision with grafting. Choose between 26210 and 26215 based on whether grafting is actually performed and documented.

The 90-day global period means all routine follow-up through day 90 — dressing changes, suture removal, and standard post-op visits — is bundled into the payment. A separate E/M during that window needs modifier 24 (unrelated condition) or, for a new problem requiring a decision for surgery, modifier 25. Modifier 79 covers an unrelated surgical procedure in the global window; modifier 78 covers an unplanned return to the OR for a complication of the original procedure.

Code selection hinges on the operative note confirming the mass is at the bone level, not the tendon sheath or soft tissue. A lesion documented only as a 'finger mass' without specifying anatomic depth — particularly bone involvement — risks downcoding to 26160 (tendon sheath lesion) or a soft-tissue excision code. Laterality modifiers (LT/RT) and finger-specific documentation are standard payer expectations for this code.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.19
Practice expense RVU	6.64
Malpractice RVU	1
Total RVU	12.83
Medicare national rate	$428.53
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	$428.53
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 26210 get rejected.

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

Operative note describes a 'finger mass' without specifying bone involvement, triggering downcoding to a soft-tissue excision code.
Missing laterality modifier (LT or RT) required by payer policy for finger procedures.
Billing 26210 and 26215 together — only one is appropriate based on whether grafting occurred.
Routine post-op E/M billed without modifier 24 during the 90-day global period.
Insufficient imaging or pathology documentation to support a bone cyst or benign tumor diagnosis.

Frequently asked questions

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

01What's the difference between 26210 and 26215?

26210 is excision or curettage of a phalangeal bone cyst or benign tumor without grafting. 26215 is the same procedure with bone grafting. Document explicitly whether a graft was placed — that single detail determines the correct code.

02Can I bill 26210 for a soft-tissue finger mass?

No. 26210 requires the lesion to originate from the phalanx bone itself. Soft-tissue masses or tendon sheath lesions on the finger use different codes such as 26160. The operative note must confirm bone-level involvement.

03Which laterality modifier applies when the procedure is on one finger?

Use LT for the left hand or RT for the right hand. Most payers require laterality on finger procedures, and omitting it is a common reason for rejection or a request for additional information.

04If I perform 26210 on two separate fingers during the same session, how do I bill?

Bill 26210 for the primary finger and 26210-51 for the additional finger on the same claim line, with LT or RT modifiers as appropriate. Document each finger's lesion separately in the operative note.

05Does the 90-day global period affect post-op imaging orders?

The global covers routine follow-up care, not diagnostic imaging ordered for a new or unrelated problem. If you order imaging to evaluate a suspected complication or unrelated condition within the 90-day window, that service can be billed separately with appropriate documentation.

06When is modifier 22 appropriate for 26210?

Use modifier 22 when the procedure is substantially more complex than typical — for example, a large lesion requiring extensive bone reconstruction, difficult anatomic location, or prolonged operative time. Attach a cover letter explaining the increased complexity; without it, payers routinely deny the additional payment request.

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 phalanx involved (proximal, middle, or distal), the surgeon's intraoperative confirmation that the lesion is at the bone level, whether a bone graft was placed, and the laterality of the finger. That detail prevents the most common denial trigger for 26210: an operative note that describes only a 'finger mass' without establishing osseous origin, which auditors use to downcode to a soft-tissue excision.

See how Mira captures CPT 26210 documentation