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See a sample rate comparisonCPT 26135 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.
Synovectomy Metacarpophalange, Synovectomy Metacarpophalangeal Joint Including Intrinsicrelease And Extensor Hood Reconstruction Each Digit Synovectomy Metacarpophalangeal Jointincluding Intrinsic
| 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 26135 |
| Medicaid Fee Schedule | View Medicaid rates for 26135 |
National average reimbursement for CPT 26135 by major payers:
$736.32
$743.82
$758.19
$917.18
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CPT 26135
5 of 25 sample ratesHigher to lower in this preview
Rock Hill Surgery Center, LLC, Carolina Surgical Center
Rock Hill Surgery Center LLC
$22,190.00Published rateSurgcenter Of Plano LLC
Surgcenter Of Plano, LLC
$3,324.00Published rateSurgery Center Of Georgetown, LLC, Georgetown Surgery Center
Surgery Center Of Georgetown LLC
$2,663.00Published rateDoctors Surgical Partnership LLC, Melbourne Same Day Surgery
Doctors Surgical Partnership LLC
$1,346.00Published rateMelissa Harmon
Deaconess Hospital Inc
$442.66Published rate
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See a sample payer proposalCPT 26135 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26135 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 26135 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). |
| 26135-CPT | Moderate | Synovectomy Metacarpophalange, Synovectomy Metacarpophalangeal Joint Including Intrinsicrelease And Extensor Hood Reconstruction Each Digit Synovectomy Metacarpophalangeal Jointincluding Intrinsic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26135. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26135 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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