CPT 26011
Global 010 ActiveDrainage of finger abscess
CPT 26011 Billing & Documentation Guide
CPT code 26011 (Drainage of finger abscess) is classified under Surgery (Musculoskeletal) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.18, a non-facility practice expense RVU of 12.87, and a malpractice RVU of 0.43, a total non-facility RVU of 15.48 and facility RVU of 5.46. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $535.22, though rates vary from $449.47 to $708.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 26011, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 26011 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 3 units of 26011 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 26011
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.18 | 2.18 |
| Practice Expense RVU | 12.87 | 2.85 |
| Malpractice RVU | 0.43 | 0.43 |
| Total RVU | 15.48 | 5.46 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 26011
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $591.87 | $195.85 | $552.89 - $708.39 | 29 |
| Florida | $532.08 | $196.28 | $505.36 - $556.63 | 3 |
| Georgia | $500.21 | $180.93 | $473.38 - $527.03 | 2 |
| Illinois | $515.88 | $192.5 | $487.73 - $540.25 | 4 |
| Michigan | $496.68 | $182.42 | $481.5 - $511.85 | 2 |
| North Carolina | $483.06 | $170.81 | $483.06 - $483.06 | 1 |
| New York | $575.36 | $201.99 | $491.29 - $615.26 | 5 |
| Ohio | $479.76 | $174.2 | $479.76 - $479.76 | 1 |
| Pennsylvania | $509.88 | $182.06 | $481.01 - $538.75 | 2 |
| Texas | $509.76 | $180.27 | $477.34 - $540.49 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 26011
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 26011 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01810 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 26011
What does CPT code 26011 mean? +
CPT code 26011 represents: Drainage of finger abscess. It's in the Surgery (Musculoskeletal) category with a global period of 010.
What is the Medicare reimbursement for CPT 26011? +
The 2026 Medicare national average non-facility payment for CPT 26011 is $535.22. Rates range from $449.47 to $708.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 26011? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 26011? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 26, 2026.
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