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See a sample rate comparisonCPT 26025 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.
I & D Palmar Bursa;Single,Ulnaror Radia
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26025 |
| Medicaid Fee Schedule | View Medicaid rates for 26025 |
National average reimbursement for CPT 26025 by major payers:
$532.27
$564.65
$571.90
$696.53
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CPT 26025
5 of 25 sample ratesHigher to lower in this preview
Short Hills Surgery Center, LLC, Short Hills Surgery Center
Short Hills Surgery Center, LLC
$3,157.00Published rateWest Asc, LLC, Camillus Surgery Center
West Asc, LLC Dba Camillus Surgery Center
$1,255.00Published rateIsurgery, LLC
Isurgery LLC
$750.00Published rateCleveland Clinic Florida (A Nonprofit Corporation), Cleveland Clinic Florida Coral Springs Asc
Cleveland Clinic Florida A Nonprofit Corporation
$618.00Published rateFt Myers Digestive Health And Pain Asc LLC, Center For Digestive Health And Pain Management
Ft Myers Digestive Health And Pain Asc LLC
$404.00Published rate
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See a sample payer proposalCPT 26025 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26025 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 26025 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 26025. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26025 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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