CPT 26373 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 • LT - Left side of body • F1 - Left hand, second digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26373 |
National average reimbursement for CPT 26373 by major payers:
$1,196.69
$1,162.55
$1,181.47
$1,481.37
| 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 26373 | ||||||
United | 26373 | $1300.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $7895.00 | 1629249172 - NORTH STATE SURGERY CENTERS LP, COURT STREET SURGERY CENTER | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $1224.00 | 1265488563 - SYRACUSE ASC, LLC, SPECIALTY SURGERY CENTER OF CNY | 161549512 - (NY) SPECIALTY SURGERY CENTER OF CNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $4600.00 | 1982607446 - DENTON SURGICARE PARTNERS, LTD., DENTON SURGICARE | 752708579 - (TX) DENTON SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $8869.00 | 1346792165 - HSS ASC OF MANHATTAN LLC, HSS ASC OF MANHATTAN | 471353602 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $720.00 | 1740277821 - TRANSSOUTH HEALTH CARE PLLC, TRANSSOUTH HEALTH CARE PC | 621453805 - (TN) TRANSSOUTH HEALTH CARE, P.C. | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $2224.00 | 1073113841 - SPINE SOLUTIONS OF WEST BEND LLC | 853661644 - (WI) SPINE SOLUTIONS OF WEST BEND LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $640.00 | 1407954365 - ASC-TCG, LLC, TRI-COUNTY CENTER FOR ENDOSCOPY & SURGERY | 43692535 - (MI) ASC - TCG LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $886.00 | 1679566582 - FOREST CANYON ENDOSCOPY & SURGERY CTR PC | 460504121 - (AZ) FOREST CANYON ENDOSCOPY & SURGERY CENTER, PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $3570.00 | 1114126596 - CORAL RIDGE OUTPATIENT CENTER LLC, CORAL RIDGE OUTPATIENT CENTER | 205429299 - (FL) CORAL RIDGE OUTPATIENT CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $5310.00 | 1467057372 - SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | 852607391 - (CT) SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $2100.00 | 1659731669 - PHOENIX ASC, LP, CARDIAC SURGERY CENTER OF PHOENIX | 474334606 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $2918.00 | 1114034006 - SURGICAL CENTER AT MILLBURN, LLC | 571166137 - (NJ) SURGICAL CENTER AT MILLBURN LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $1035.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26373 | $614.00 | 1528307188 - SGFC SURGERY CENTER, LLC, SGFC SURGERY CENTER | 208131466 | MD | 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 26373 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26373 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 26373 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 |
|---|---|---|
| 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) |
| 26358-CPT | High | 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 |
| 26373-CPT | High | Rep Tendon Profundus Second Wo Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26373. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26373 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 26373) and we'll show you how you compare in 15 minutes or less.