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See a sample rate comparisonHealthcare 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.
| 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 | None 59 - Distinct Procedural Service F7 - Right hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26110 |
| Medicaid Fee Schedule | View Medicaid rates for 26110 |
National average reimbursement for CPT 26110 by major payers:

$465.93

$430.92

$441.11

$539.93
Choose a payer to see a sample of rates for CPT 26110.
West Orange Asc LLC
Surgcenter Of Deer Valley LLC
Endotech LLC
Arizona Digestive Center PC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 26110 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26110 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 26110 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 26110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26110 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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