CPT 26011 Fee Schedule

Medicare rates as of October 2026

CPT 26011 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.

Drainage Finger Abscess;Complicated-Eg,F

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Musculoskeletal System
Common Place of Service	21 - Inpatient Hospital 23 - Emergency Room
Common Modifiers	F6 - Right hand, second digit F7 - Right hand, third digit
Complexity Level	Moderate
Medicare Fee Schedule	$517.05 national non-facility rate (2026) · View Medicare rates for 26011
Medicaid Fee Schedule	$405.29 median of the 8 states in the free preview · View Medicaid rates for 26011

National average reimbursement for CPT 26011 by major payers:

$513.22

BCBS / Anthem

$554.38

UnitedHealthcare

$618.57

Aetna

$725.91

Cigna

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CPT 26011

5 of 25 sample ratesHigher to lower in this preview

Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
WIAmbulatory Surgical Clinic/CenterNPI 1659839686Tax ID 81-1401714
$3,024.00Published rate
Texan Ambulatory Surgery Center, Texan Surgery Center
TXAmbulatory Surgical Clinic/CenterNPI 1851433718Tax ID 33-1058382
$1,528.00Published rate
Rads Of America, LLC, Premier Radiology Pain Management Center
Rads Of America LLC
TNAmbulatory Surgical Clinic/CenterNPI 1619071214Tax ID 20-0597581
$932.00Published rate
Asc Development Company, LLC
Asc Development Company LLC
MDAmbulatory Surgical Clinic/CenterNPI 1619221801Tax ID 20-3405773
$565.00Published rate
Houma Surgi-Center, Inc & Urology Clinic
Houma Surgi-Center & Urology Clinic (Amc)
LAAmbulatory Surgical Clinic/CenterNPI 1003895152Tax ID 72-0846620
$423.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 26011 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The table lists codes related to 26011. Select one to see its fee schedule.

Code	Complexity	Description
26010-CPT	Moderate	Drain Finger Abscess
26011-CPT	Moderate	Drainage Finger Abscess;Complicated-Eg,F
26020-CPT	Moderate	Drain Tendon Sheath Digit/Palm
26030-CPT	Moderate	Drain Palm Bursa Mult/Complicated

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 26011 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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