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 26105 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.
Hand Surgery For Biopsy, Surgery To Explore A Joint In The Hand. The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26105 |
| Medicaid Fee Schedule | View Medicaid rates for 26105 |
National average reimbursement for CPT 26105 by major payers:
$468.65
$452.83
$458.81
$566.22
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 26105.
CPT 26105
5 of 25 sample ratesHigher to lower in this preview
New Port Richey Surgery Center Ltd
$5,532.00Published rateGulfshore Endoscopy Center LLC
$1,276.00Published rateIdaho Endoscopy Center LLC, Nampa Idaho Endoscopy Center
Idaho Endoscopy Center LLC
$950.00Published rateSacramento Heart Ambulatory Surgery Center, Inc
Sacramento Heart Ambulatory Surgery Center Inc
$700.00Published rateBellevue Plastic Surgery Center, Newvue Plastic Surgery PC
Newvue Plastic Surgery, PC
$385.00Published 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 26105 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26105 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 26105 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 |
|---|---|---|
| 26100-CPT | Moderate | Hand Surgery For Biopsy, Surgery To Explore A Joint In The Hand. The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy). |
| 26105-CPT | Moderate | Hand Surgery For Biopsy, Surgery To Explore A Joint In The Hand. The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy). |
| 26110-CPT | Moderate | Finger Joint Exploration, Surgery To Explore A Finger Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
| 26130-CPT | Moderate | Removal Of Hand Joint Lining, Surgery To Remove Lining Of Hand Joint. The Procedure Is Done To Relieve Pain Caused By Inflamed Lining. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26105 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 26105) and we'll show you how you compare in 15 minutes or less.