CommercialCoverageHigh impact
Outpatient Surgical Procedures – Site of Service
UnitedHealthcare·Orthopedics, General Surgery, Plastic Surgery·Medical Policy
Effective date
Aug 1, 2026
We identified it
Jul 2, 2026
Summary
UnitedHealthcare removed 8 CPT codes (26530, 26535, 29800, 29804, 29805, 29830, 29840, 29860) from coverage for outpatient surgical procedures effective August 1, 2026 on commercial plans. The policy also updated definitions for ASA Physical Status Classification and Poorly Controlled Hypertension, and added a reference link to wrist/thumb surgery policy.
Action Required
By July 31, 2026: Billing team must update billing software to remove or flag CPT codes 26530, 26535, 29800, 29804, 29805, 29830, 29840, and 29860 from automatic billing for UnitedHealthcare commercial plans. Remove these codes from encounter templates and charge capture systems. Notify clinical staff and providers that these hand/wrist/ankle procedures are no longer covered as outpatient procedures under this policy—alternate settings or prior authorization may be required. Update denial management rules to expect rejections for these codes and route claims appropriately. Failure to implement this change will result in claim denials and revenue loss. Reference the related Surgery of the Wrist or Thumb policy for guidance on covered alternatives.