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See a sample rate comparisonCPT 26428 Fee Schedule
Last Verified: September 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 Graft Finger Tendon, Repair Of Extensor Tendon Central Slip Secondary Eg Boutonniere Deformity With Free Graft Includes Obtaining Graft Each Finger
| 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 F7 - Right hand, third digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26428 |
| Medicaid Fee Schedule | View Medicaid rates for 26428 |
National average reimbursement for CPT 26428 by major payers:
$1,026.64
$1,033.97
$1,061.77
$1,299.87
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CPT 26428
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$9,270.00Published rateSurgcenter Of Glen Burnie, Surgcenter Of Glen Burnie, LLC
Surgcenter Of Glen Burnie, LLC
$3,500.00Published rateMvh Endoscopy LLC, Pcs Endoscopy Suite
Mvh Endoscopy LLC
$2,243.00Published rateSmart Pain Surgery Center At Owings Mills, LLC, Clearway Surgery Center Of Owings Mills
Smart Pain Surgery Center At Owings Mills LLC
$1,334.00Published rateTri-State Gastroenterology Associates, Psc, Tri-State Digestive Disorder Center
Tri-State Gastroenterology Associates, Psc
$734.00Published rate
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See a sample payer proposalCPT 26428 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26428 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 26428 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 |
|---|---|---|
| 26428-CPT | High | Repair Graft Finger Tendon, Repair Of Extensor Tendon Central Slip Secondary Eg Boutonniere Deformity With Free Graft Includes Obtaining Graft Each Finger |
| 26432-CPT | Moderate | Splint Injured Tendon, Treatment Of Finger Tendon Injury Using A Splint. Pins May Be Inserted Through The Skin To Stabilize The Finger Joint. |
| 26433-CPT | Moderate | Repair Finger Tendon, Repair Of Finger Tendon On The Top Side Of The Hand (Extensor) Without A Graft Toward The End Of The Finger (Mallet Finger) |
| 26434-CPT | Moderate | Repair/Graft Finger Tendon, Repair Of Finger Tendon On The Top Side Of The Hand (Extensor) Without A Graft Toward The End Of The Finger (Mallet Finger) With A Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26428 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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