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See a sample rate comparisonCPT 26420 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.
Hand/Finger Surgery, Extensor Tendon Repair Dorsum Of Finger Single Primary Or Secondary; With Free Graft (Includes Obtaining 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 F7 - Right hand, third digit F1 - Left hand, second digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26420 |
| Medicaid Fee Schedule | View Medicaid rates for 26420 |
National average reimbursement for CPT 26420 by major payers:
$1,008.53
$974.79
$1,004.17
$1,221.76
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CPT 26420
5 of 25 sample ratesHigher to lower in this preview
The Western Pennsylvania Hospital, Forbes Regional Campus
Highmark Health
$8,541.08Published rateSaint Barnabas Outpatient Centers, Ambulatory Surgery Center
Saint Barnabas Outpatient Centers
$2,186.00Published rateAxis Surgery Center LLC
$1,500.00Published rateUnited Skin Specialists Missouri Ltd, PC, Chesterfield Asc
$1,000.00Published rateThe Surgery & Endoscopy Center LLC
The Surgery Endoscopy Center LLC
$510.00Published rate
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See a sample payer proposalCPT 26420 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26420 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 26420 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 |
|---|---|---|
| 26392-CPT | High | Removal Of Prosthetic Rod And, Removal Of Prosthetic Rod And Insertion Of Flexor Tendongraft Hand Or Finger (Includes Obtaining Graft) Each Tendon |
| 26412-CPT | High | Repair Graft Hand Tendon, Repair Extensor Tendon Hand Primary Or Secondary With Free Graft Includes Obtaining Graft Each Tendon |
| 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 |
| 26420-CPT | High | Hand/Finger Surgery, Extensor Tendon Repair Dorsum Of Finger Single Primary Or 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 26420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26420 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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