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See a sample rate comparisonCPT 26080 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.
Explore Treat Finger Joint, Arthrotomy With Exploration Drainage Or Removal Of Loose Or Foreign Body Interphalangeal Joint Each
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service F7 - Right hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26080 |
| Medicaid Fee Schedule | View Medicaid rates for 26080 |
National average reimbursement for CPT 26080 by major payers:
$536.49
$523.03
$553.15
$672.63
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CPT 26080
5 of 25 sample ratesHigher to lower in this preview
Saint Vincent Hlth Ctr Spu
Highmark Health
$4,223.39Published rateMnh Gi Surgical Center LLC, Mnh Surgical Center
$1,276.00Published rateAnnapolis Ent Surgical Center, LLC
$760.00Published rateUsc, LLC, Unasource Surgery Center
Usc, LLC
$603.00Published rateStephen Koster
Deaconess Hospital Inc
$314.39Published rate
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See a sample payer proposalCPT 26080 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26080 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 26080 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 |
|---|---|---|
| 26060-CPT | Moderate | Surgery On Finger Tendon, Surgery To Cut The Tendon In The Finger. The Procedure Lengthens The Tendon Or Releases A Contracted Tendon. |
| 26070-CPT | Moderate | Arthrotomy W/ Explora Drain Or Remval Of Loose Or Foreign, Arthrotomy With Exploration Drainage Or Removal Of Loose Or Foreign |
| 26075-CPT | Moderate | Explore Treat Finger Joint, Arthrotomy With Exploration Drainage Or Removal Of Loose Or Foreign Body Metacarpophalangeal Joint Each |
| 26080-CPT | Moderate | Explore Treat Finger Joint, Arthrotomy With Exploration Drainage Or Removal Of Loose Or Foreign Body Interphalangeal Joint Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26080 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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