CPT 26352 Fee Schedule
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.
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 26352 |
National average reimbursement for CPT 26352 by major payers:
$1,158.48
$1,104.81
$1,162.16
$1,410.76
| 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 26352 | ||||||
United | 26352 | $1142.00 | 1922193515 - MAHONING VALLEY AMBULATORY SURGERY CENTER INC | 233056394 - (PA) MAHONING VALLEY AMBULATORY SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $1761.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $3085.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $3210.00 | 1750491205 - ENT SURGERY CENTER OF ATLANTA,LLC | 200075229 - (GA) ENT SURGERY CENTER OF ATLANTALLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $2300.00 | 1942239751 - POSADA AMBULATORY SURGERY CENTER, LP | 571140323 - (CA) POSADA AMBULATORY SURGERY CENTER, L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $2096.00 | 1396896684 - DREYER AMBULATORY SURGERY CENTER, LLC | 363890298 - (IL) DREYER AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $1427.00 | 1194744532 - MOSES CONE MEDICAL SERVICES INC., LEBAUER ENDOSCOPY CENTER | 561714318 - MOSES CONE MEDICAL SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $4436.25 | 1629664156 - OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER, OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER NEW ALBANY | 854149946 - (OH) OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $1632.00 | 1427307578 - HEMLOCK AMBULATORY SURGERY CENTER | 455511791 - (GA) HEMLOCK AMBULATORY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $2799.00 | 1144333881 - NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC | 200554616 - (AZ) NORTH SCOTTSDALE AMBULATORY SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $788.00 | 1528061918 - CATARACT SPECIALTY SURGICAL CENTER, LLC, CATARACT SPECIALTY SURGICAL CENTER | 200225369 - (MI) CATARACT SPECIALTY SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $2112.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 472361569 - (RI) ORTHOPEDICS RHODE ISLAND, INC. | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $700.00 | 1922144484 - INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | 202908826 - (MO) INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $3350.00 | 1801974720 - SUMMIT SURGICAL CENTER, LLC | 731730859 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26352 | $1308.00 | 1992709851 - NOVAMED SURGERY CENTER OF CHICAGO-NORTHSHORE, LLC | 50540721 - (IL) NOVAMED SURGERY CENTER OF CHICAGONORTHSHORE LLC | IL | 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 |
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CPT 26352 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26352 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 26352 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 |
|---|---|---|
| 26350-CPT | High | Repair Or Advancement, Flexor Tendon, Not In Zone 2 Digital Flexor Tendon Sheath (Eg, No Man S Land); Primary Or Secondary Without Free Graft, Each Tendon |
| 26352-CPT | High | Repair Or Advancement, Flexor Tendon, Not In Zone 2 Digital Flexor Tendon Sheath (Eg, No Man S Land); Secondary With Free Graft (Includes Obtaining Graft), Each Tendon |
| 26356-CPT | High | Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath (Eg No Mans Land); Primary Without Free Graft Each Tendon(Rvsd 1/1/04 ) |
| 26357-CPT | High | Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath (Eg No Mans Land); Secondary Without Free Graft Each Tendon (Rvsd 1/1/04) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26352. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26352 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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