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See a sample rate comparisonCPT 26250 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Resect Metacarpal Radical
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26250 |
| Medicaid Fee Schedule | View Medicaid rates for 26250 |
National average reimbursement for CPT 26250 by major payers:
$1,338.68
$1,297.23
$1,400.38
$1,645.16
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CPT 26250
5 of 25 sample ratesHigher to lower in this preview
Indiana University Health Saxony Surgery Center LLC, Saxony Surgery Center
$2,307.00Published rateIreland Grove Center For Surgery LLC.
Ireland Grove Center For Surgery, LLC
$1,500.00Published rateCentral Park Endoscopy Center LLC, Endoscopy Center At Central Park
Central Park Endoscopy Center LLC
$1,022.00Published ratePacific Cataract And Laser Institute, Inc., P.C.
Pacific Cataract And Laser Institute, Inc., PC
$624.00Published rateHarvard Surgery Center LLC
$325.00Published rate
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See a sample payer proposalCPT 26250 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26250 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 26250 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 |
|---|---|---|
| 26236-CPT | Moderate | Partial Removal Finger Bone, Partial Excision Craterization Saucerization Or Diaphysectomy Bone Eg Osteomyelitis Distal Phalanx Of Finger |
| 26250-CPT | High | Resect Metacarpal Radical |
| 26260-CPT | High | Radical Resct Of Tumor Proxim Or Middle Phalanx Of Finger, Radical Resection Of Tumor Proximal Or Middle Phalanx Of Finger |
| 26262-CPT | Moderate | Radical Resct Of Tumor Distal Phalanx Of Finger, Radical Resection Of Tumor Distal Phalanx Of Finger |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26250 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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