CPT 26432 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • F9 - Right hand, fifth digit • F7 - Right hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26432 |
National average reimbursement for CPT 26432 by major payers:
$717.34
$687.34
$735.12
$901.48
| 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 26432 | ||||||
United | 26432 | $330.00 | 1538154604 - PAIN MANAGEMENT & SURGERY CENTER OF SOUTHERN INDIANA | 351972676 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $766.00 | 1225058068 - PROCEDURE CENTER OF IRVINE INC., PROCEDURE CENTER OF IRVINE | 330932503 - (CA) PROCEDURE CENTER OF IRVINE INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $2169.00 | 1578741849 - SCOTT AND WHITE HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR | 741595711 - (TX) SCOTT & WHITE HOSPITAL-TAYLOR | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $1258.00 | 1124125604 - MURDOCK AMBULATORY SURGERY CENTER LLC | 201543128 - (FL) MURDOCK AMBULATORY SURGERY CENTE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $901.00 | 1396771036 - THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | 30426509 - (VA) THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $803.00 | 1033105960 - SURGERY CENTER OF OAK RIDGE, LLC, ADVANCED FAMILY SURGERY CENTER | 621801416 - (TN) ADVANCED FAMILY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $477.00 | 1578994265 - M/S SURGERY CENTER LLC, M/S SURGERY CENTER LLC WHIT | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $2042.00 | 1942231204 - SURGICAL INSTITUTE, LLC | 810911558 - (NJ) SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $604.00 | 1932709490 - LUNATE SURGERY CENTER | 853581951 - (GA) LUNATE SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $832.00 | 1841507266 - SOUTH PORTLAND SURGICAL CENTER LLC, SOUTH PORTLAND SURGICAL CENTER | 800461691 - (OR) SOUTH PORTLAND SURGICAL CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $852.29 | 1295933810 - KURT LANCASTER | 350593390 - DEACONESS HOSPITAL INC | MO | Anesthesiology Physician (207L00000X) |
United | 26432 | $771.00 | 1487221404 - EYE SURGICAL SERVICES LLC, GATEWAY SURGERY CENTER | 834616432 - (MO) EYE SURGICAL SERVICES, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $715.00 | 1720572415 - APC-AMARILLO SURGICAL OPERATING COMPANY, LLC, ADVANCED SURGICAL CENTER - AMARILLO | 822413483 - (TX) APCAMARILLO SURGICAL OPERATING COMPANY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $1028.00 | 1477089126 - BISMARCK SINUS CENTER | 821303553 - (ND) BISMARCK SINUS CENTER | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26432 | $575.00 | 1376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC | 161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLC | PA | 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 26432 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26432 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 26432 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 Of Extensor Tendon, Central Slip, Secondary (Eg, Boutonniere Deformity); With Free Graft (Includes Obtaining Graft), Each Finger |
| 26432-CPT | Moderate | Extensor Tendon Repair, Distal Insertion (''mallet Finger''), Closed, Splinting With Or Without Percutaneous Pin |
| 26433-CPT | Moderate | Rep Tendon Extensor Finger Open |
| 26434-CPT | Moderate | Extensor Tendon Repair, Distal Insertion ( Mallet Finger ), Open, Primary Or Secondary Repair; With Free Graft (Include |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26432. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26432 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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