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See a sample rate comparisonCPT 26230 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.
Partial Xcision (Craterizat Saucerizati Or Diaphysectomy) Bone, Partial Excision (Craterization Saucerization Or Diaphysectomy) Bone
| 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 |
| Medicare Fee Schedule | View Medicare rates for 26230 |
| Medicaid Fee Schedule | View Medicaid rates for 26230 |
National average reimbursement for CPT 26230 by major payers:
$688.45
$673.51
$703.24
$827.83
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CPT 26230
5 of 25 sample ratesHigher to lower in this preview
Paramus Endoscopy LLC, Endoscopy Center Of Bergen County
Paramus Endoscopy LLC
$2,974.00Published rateChandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
$1,276.00Published rateBeaumont Asc, Lp, Beaumont Heart & Vascular Surgery Center
$875.00Published rateEhlers Eye Surgery LLC
$523.00Published rateDel Val Asc LLC, The Eye Surgery Center
Del Val Asc LLC
$350.00Published rate
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See a sample payer proposalCPT 26230 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26230 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 26230 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 | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones In The Hand. |
| 26205-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 26210-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Finger Bones. The Area May Be Repaired With A Bone Graft. |
| 26230-CPT | Moderate | Partial Xcision (Craterizat Saucerizati Or Diaphysectomy) Bone, Partial Excision (Craterization Saucerization Or Diaphysectomy) Bone |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26230 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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