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See a sample rate comparisonCPT 26418 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Rpair Extenso Tndon Finger Primar Or Second; W/O Free Gr, Repair Extensor Tendon Finger Primary Or Secondary; Without Free Gr
| 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 FA - Left hand, thumb F1 - Left hand, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26418 |
| Medicaid Fee Schedule | View Medicaid rates for 26418 |
National average reimbursement for CPT 26418 by major payers:
$858.52
$795.04
$865.09
$1,018.10
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CPT 26418
5 of 25 sample ratesHigher to lower in this preview
St. Clair Memorial Hospital
St Clair Health Corporation
$4,731.62Published ratePacific Gastroenterology Endoscopy Center
$1,200.00Published rateIspm Asc At Covington, LLC
Ispm Asc At Covington LLC
$800.00Published ratePacific Cataract And Laser Institute Inc PC
Pacific Cataract And Laser Institute, Inc., PC
$624.00Published rateRiverwalk Ambulatory Surgery Center LLC
Riverwalk Ambulatory Surgery Center, LLC
$435.00Published rate
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See a sample payer proposalCPT 26418 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26418 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 26418 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 |
|---|---|---|
| 26412-CPT | High | Repair Graft Hand Tendon, Repair Extensor Tendon Hand Primary Or Secondary With Free Graft Includes Obtaining Graft Each Tendon |
| 26415-CPT | High | Hand Or Finger Tendon Surgery, Surgery To Remove A Tendon From A Hand Or Finger. A Temporary Rod Is Implanted To Prepare The Surrounding Tissue For A Tendon Graft. |
| 26416-CPT | High | Graft Hand Or Finger Tendon, Removal Of Prosthetic Rod And Insertion Of Extensor Tendon Graft (Includes Obtaining Graft) Hand Or Finger Each Tendon |
| 26418-CPT | Moderate | Rpair Extenso Tndon Finger Primar Or Second; W/O Free Gr, Repair Extensor Tendon Finger Primary Or Secondary; Without Free Gr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26418. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26418 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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