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26111 Exc hand les sc 1.5 cm/>

What 26111 is

CMS fee schedule short descriptor: Exc hand les sc 1.5 cm/>.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 26111 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)5.285.451.0411.77$393.13
Facility (hospital, ASC)5.285.451.0411.77$393.13

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

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Medically Unlikely Edit (MUE)

Medicare caps 26111 at 4 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 26111? These codes are bundled into it

26111 is a Column 1 code in 281 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01810Anes px nrv musc f/arm wrst0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0490TRegn cell tx scldr h mlt inj1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0718TAdrc ther prtl rc tear njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10005Fna bx w/us gdn 1st les1 - modifier may bypassCheck pair
10007Fna bx w/fluor gdn 1st les1 - modifier may bypassCheck pair
10009Fna bx w/ct gdn 1st les1 - modifier may bypassCheck pair
10011Fna bx w/mr gdn 1st les1 - modifier may bypassCheck pair
10021Fna bx w/o img gdn 1st les1 - modifier may bypassCheck pair
10030Img gid flu coll drg sft tis1 - modifier may bypassCheck pair
10060I&d abscess simple/single1 - modifier may bypassCheck pair
10140I&d hmtma seroma/fluid collj1 - modifier may bypassCheck pair
10160Pnxr aspir absc hmtma bulla1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11010Debride skin at fx site1 - modifier may bypassCheck pair
11011Debride skin musc at fx site1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair

Showing 30 of 281 column 2 codes. Use the pair checker for any specific combination.

26111 is bundled into these codes

26111 appears as a Column 2 code in 25 active edits. Reported with one of these Column 1 codes on the same date of service, 26111 is the code that denies.

Column 1 codeShort descriptionModifier indicator
25116Remove wrist/forearm lesion1Check pair
26030Drainage of palm bursas1Check pair
26113Exc hand tum deep 1.5 cm/>1Check pair
26116Exc hand tum deep < 1.5 cm1Check pair
26117Rad resect hand tumor < 3 cm1Check pair
26118Rad resect hand tumor 3 cm/>1Check pair
26200Remove hand bone lesion1Check pair
26205Remove/graft bone lesion1Check pair
26210Removal of finger lesion1Check pair
26215Remove/graft finger lesion1Check pair
26230Partial removal of hand bone1Check pair
26235Partial removal finger bone1Check pair
26236Partial removal finger bone1Check pair
26250Extensive hand surgery1Check pair
26260Resect prox finger tumor1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.