CPT 26392 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 • F9 - Right hand, fifth digit • F8 - Right hand, fourth digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26392 |
National average reimbursement for CPT 26392 by major payers:
$1,336.53
$1,329.67
$1,359.99
$1,685.20
| 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 26392 | ||||||
United | 26392 | $4277.00 | 1346468253 - FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC | 208335586 - (MN) FAIRVIEW MAPLE GROVE SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $4140.00 | 1962681130 - BAYLOR SURGICARE AT PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE - PLANO | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $4302.00 | 1851407399 - SOUTHERN NEW MEXICO SURGERY CENTER, LLC | 201826172 - (NM) SOUTHERN NEW MEXICO SURGERY CENTER | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $2960.00 | 1952540825 - ROME ORTHOPAEDIC CLINIC ASC, INC. | 261595646 - (GA) ROME ORTHOPAEDIC CLINIC ASC INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $2393.00 | 1477655801 - CATARACT AND LASER CENTER ASSOCIATES PC | 43359062 - (MA) CATARACT AND LASER CENTER ASSOCIATES PC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $1878.00 | 1639499627 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC MARIETTA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $2750.00 | 1720227945 - WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC, THE HAND CENTER OF WESTERN CONNECTICUT LLC | 61521999 - (CT) THE HAND CENTER OF WESTERN CONNECTICUT, L.L.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $1666.71 | 1669959706 - SIMEON GOTZEV | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 26392 | $1248.00 | 1184699241 - SAN LUIS OBISPO CA ENDOSCOPY ASC LP, TEMPLETON ENDOSCOPY CENTER | 201965605 - (CA) SAN LUIS OBISPO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $4691.00 | 1174591143 - SILICON VALLEY SURGERY CENTER, LP | 770495522 - (CA) SILICON VALLEY SURGERY CENTER, L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $2380.00 | 1457976383 - VHC-I | 851094630 - (AZ) VHCI | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $691.00 | 1104894369 - VALLEY OUTPATIENT SURGICAL CENTER INC | 860585124 - (AZ) VALLEY OUTPATIENT SURGICAL CENTER INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $1600.00 | 1154554160 - CABRILLO SURGERY CENTER | 270666008 - (CA) CABRILLO SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $3347.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26392 | $1763.00 | 1093748527 - WOODHAMS LASER & LENS IMPLANT CENTER LLC | 582631668 - (GA) WOODHAMS LASER LENS IMPLANT CENTER LLC | GA | 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 26392 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26392 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 26392 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 |
|---|---|---|
| 26372-CPT | High | Repair Or Advancement Of Profundus Tendon, With Intact Superficialis Tendon; Secondary With Free Graft (Includes Obtaining Graft), Each Tendon |
| 26390-CPT | High | Flex Tendon Excis Implant Plastic Tube/R |
| 26392-CPT | High | Removal Rod W Insert Tendon Graft |
| 26412-CPT | High | Rep Tendon Extensor Hand W Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26392. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26392 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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