CPT 26200 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 26200 by major payers:
$627.96
$607.02
$622.49
$765.82
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 26200 | ||||||
United | 26200 | $734.00 | 1295700086 - WESTERN WASHINGTON ENDOSCOPY CENTERS, LLC | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $644.00 | 1932430816 - SURGCENTER OF GREENBELT, LLC | 270408064 - (MD) SURGCENTER OF GREENBELT LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $500.00 | 1922262278 - EPS SURGICAL CENTER, LLC | 260875908 - (GA) EPS SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $575.00 | 1427307578 - HEMLOCK AMBULATORY SURGERY CENTER | 455511791 - (GA) HEMLOCK AMBULATORY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $867.00 | 1295714301 - ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP, ENDOSCOPY CENTER OF SOUTHEAST TEXAS | 621536529 - (TX) ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $618.00 | 1184072308 - MARYLAND SURGERY CENTER FOR WOMEN | 522215638 - (MD) MARYLAND SURGERY CENTER FOR WOMEN, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $625.00 | 1194815639 - CEDAR ORTHOPAEDIC SURGERY CENTER, LLC | 200208975 - (UT) CEDAR ORTHOPAEDIC SURGERY CENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $1249.29 | 1013984657 - MAYFAIR DIGESTIVE HEALTH CENTER, LLC | 50525982 - (WI) MAYFAIR DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $1886.00 | 1245749258 - FOCUS HAND SURGICENTER LLC, FOCUS HAND AND ARM SURGERY CENTER | 822523843 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $1528.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $461.00 | 1033734793 - NAPLES SUNCOAST SURGERY CENTER, LLC | 842343047 - (FL) NAPLES SUNCOAST SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $1276.00 | 1194723981 - GREENWOOD ASC LLC, GREENWOOD AMBULATORY SURGERY CENTER | 331021175 - (CO) GREENWOOD ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $487.00 | 1992784821 - EYE SURGERY CENTER OF CHESTER COUNTY, LLC, VISION ONE LASER & SURGERY CENTER | 232922796 - (PA) EYE SURGERY CENTER OF CHESTER COUNTY, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $1642.00 | 1770559759 - RALEIGH PLASTIC SURGERY CENTER INC | 561067994 - (NC) RALEIGH PLASTIC SURGERY CENTER, INC. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26200 | $565.00 | 1972156842 - NORMAN REGIONAL HOSPITAL AUTHORITY, MEDICAL PLAZA ENDOSCOPY | 736048282 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 26200 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26200 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 26200 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 |
|---|---|---|
| 26200-CPT | Moderate | Exc Lesion Metacarpal |
| 26205-CPT | Moderate | Exc/Cur-Cyst/Tumr-Metacarpl;Autogft |
| 26210-CPT | Moderate | Exc Lesion Phalanx |
| 26215-CPT | Moderate | Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Proximal, Middle, Or Distal Phalanx Of Finger; With Autograft (Includes Obtaining Graft) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26200 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 26200) and we'll show you how you compare in 15 minutes or less.