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See a sample rate comparisonCPT 26433 Fee Schedule
Medicare rates as of October 2026
CPT 26433 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | F9Right hand, fifth digit F7Right hand, third digit |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600450Sign up to view all 6 |
| Medicare Fee Schedule | $567.82 national non-facility rate (2026)View Medicare rates for 26433 |
| Medicaid Fee Schedule | $462.05 median of the 8 states in the free previewView Medicaid rates for 26433 |
National average reimbursement for CPT 26433 by major payers:
$767.91
BCBS / Anthem
$733.23
UnitedHealthcare
$768.60
Aetna
$933.72
Cigna
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CPT 26433
5 of 25 sample ratesHigher to lower in this preview
Grass Valley Outpatient Surgery Center Lp, Grass Valley Surgery Center
$2,787.00Published rateWindsor Mill Surgery Center, LLC
Windsor Mill Surgery Center LLC
$1,233.00Published rateCenter For Urologic Surgery LLC
$725.00Published rateSsc Holdings LLC, Sedona Surgery Center
Ssc Holdings LLC
$591.00Published rateChildren'S Surgery Center Of Philadelphia LLC, Children'S Dental Surgery Of Philadelphia
Childrens Surgery Center Of Philadelphia LLC
$414.00Published rate
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See a sample payer proposalCPT 26433 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 26433. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 26428-CPT | Repair Graft Finger Tendon, Repair Of Extensor Tendon Central Slip Secondary Eg Boutonniere Deformity With Free Graft Includes Obtaining Graft Each Finger |
| 26432-CPT | 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 | 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 | 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 26433. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26433 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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Frequently Asked Questions
What APC is CPT 26433 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 26433 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 26433 in an ambulatory surgery center?
CMS lists CPT 26433 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 26433?
Hospital price transparency files list CPT 26433 under these revenue codes: including 0360, 0450, 0490, 0960 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.