Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 26020 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Drain Tendon Sheath Digit/Palm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body F7 - Right hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26020 |
| Medicaid Fee Schedule | View Medicaid rates for 26020 |
National average reimbursement for CPT 26020 by major payers:
$715.30
$663.20
$707.47
$847.95
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 26020.
CPT 26020
5 of 25 sample ratesHigher to lower in this preview
Lone Star Endoscopy Center LLC
$2,172.00Published rateGeorgia Surgical Center On Peachtree, LLC
Georgia Surgical Center On Peachtree LLC
$1,024.00Published rateWatauga Surgical Partners PLLC
$794.00Published rateBolsa Outpatient Surgery Center A Medical Corporation
$515.00Published rateAmbulatory Foot And Ankle Center, Inc.
Ambulatory Foot And Ankle Center Inc
$229.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 26020 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26020 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 26020 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 26020-CPT | Moderate | Drain Tendon Sheath Digit/Palm |
| 26025-CPT | Moderate | I & D Palmar Bursa;Single,Ulnaror Radia |
| 26030-CPT | Moderate | Drain Palm Bursa Mult/Complicated |
| 26034-CPT | Moderate | Ncision Bone Cortex Hand/ Finger (Eg Osteomyeli Or Bone Absce, Incision Bone Cortex Hand Or Finger (Eg Osteomyelitis Or Bone Absce |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26020 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 26020) and we'll show you how you compare in 15 minutes or less.