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See a sample rate comparisonCPT 26160 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.
Remove Tendon Sheath Lesion, Excision Of Lesion Of Tendon Sheath Or Joint Capsule Eg Cyst Mucous Cyst Or Ganglion Hand Or Finger
| 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 F7 - Right hand, third digit F2 - Left hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26160 |
| Medicaid Fee Schedule | View Medicaid rates for 26160 |
National average reimbursement for CPT 26160 by major payers:
$718.31
$764.46
$847.35
$548.14
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CPT 26160
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$3,776.00Published rateAloe Surgical Center Scottsdale, LLC
Aloe Surgical Center Scottsdale LLC
$1,258.00Published rateGeorgia Eye Surgicenter, LLC, Georgia Eye Institute Surgery Center
$984.00Published rateCcrm Dfw, LLC, Ccrm Dallas Fort Worth
$544.00Published rateEndoscopy Associates, LLC
Endoscopy Associates LLC
$400.00Published rate
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See a sample payer proposalCPT 26160 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26160 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 26160 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 |
|---|---|---|
| 26145-CPT | Moderate | Synovectomy Tendon Sheath Ra, Synovectomy Tendon Sheath Radical (Tenosynovectomy)Flexor Tendon Palm Andor Finger Each Tendonsynovectomy Tendon Sheath Radical (Tenosynovec Tomy) |
| 26160-CPT | Moderate | Remove Tendon Sheath Lesion, Excision Of Lesion Of Tendon Sheath Or Joint Capsule Eg Cyst Mucous Cyst Or Ganglion Hand Or Finger |
| 26170-CPT | Moderate | Excision Of Tendon,Palm,Flexor,Single,Ea |
| 26180-CPT | Moderate | Excision Of Tendon, Finger, Flexor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26160 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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