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See a sample rate comparisonCPT 26356 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.
Repair Finger Hand Tendon, Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath Eg No Man S Land Primary Without Free Graft Each Tendon
| 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 F9 - Right hand, fifth digit 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26356 |
| Medicaid Fee Schedule | View Medicaid rates for 26356 |
National average reimbursement for CPT 26356 by major payers:
$1,207.17
$1,202.01
$1,259.74
$1,418.80
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CPT 26356
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$10,099.00Published rateNorthwest Ambulatory Surgery Services, LLC, Bellingham Ambulatory Surgery Center
Northwest Ambulatory Surgery Services, LLC
$2,884.00Published rateStonegate Surgery Center Lp
$2,120.00Published rateSimeon Zou
Deaconess Hospital Inc
$1,387.31Published rateBay Area Endoscopy Center Limited Partnership
$360.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 26356 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26356 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 26356 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 |
|---|---|---|
| 26352-CPT | High | Repair Graft Hand Tendon, 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 Finger Hand Tendon, Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath Eg No Man S Land Primary Without Free Graft Each Tendon |
| 26357-CPT | High | Repair Finger Hand Tendon, Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath Eg No Man S Land Secondary Without Free Graft Each Tendon |
| 26358-CPT | High | Repair Graft Hand Tendon, Repair Or Advancement Flexor Tendon In Zone 2 Digital Flexor Tendon Sheath Eg No Man S Land Secondary With Free Graft Includes Obtaining Graft Each Tendon |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26356 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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