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See a sample rate comparisonCPT 26034 Fee Schedule
Last Verified: October 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.
Ncision Bone Cortex Hand/ Finger (Eg Osteomyeli Or Bone Absce, Incision Bone Cortex Hand Or Finger (Eg Osteomyelitis Or Bone Absce
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient 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 26034 |
| Medicaid Fee Schedule | View Medicaid rates for 26034 |
National average reimbursement for CPT 26034 by major payers:
$768.64
$726.01
$768.26
$924.18
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CPT 26034
5 of 25 sample ratesHigher to lower in this preview
Oakhurst Endoscopy Asc LLC, Ocean Surgical Pavilion, Inc.
$1,714.00Published rateSurgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$1,179.00Published rateBrookings Ambulatory Surgery Center, LLP
Brookings Ambulatory Surgery Center LLP
$750.00Published rateSurgery Center Jv, The Surgery Center Of Huntsville
The Surgery Center Of Huntsville
$588.00Published ratePremier Endoscopy Center,LLC
$383.00Published rate
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See a sample payer proposalCPT 26034 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26034 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 26034 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 |
|---|---|---|
| 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 |
| 26035-CPT | High | Dcompress Fingers &/Or Hand Inject Njury (Eg Grease Gun), Decompression Fingers And/Or Hand Injection Injury (Eg Grease Gun) |
| 26037-CPT | Moderate | Surgery To Relieve Hand Pain, Surgery To Cut Fascia (Strong Connective Tissue That Surrounds Muscle Bone And Organs) In Hand To Relieve Pressure. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26034. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26034 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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