CPT 26433 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • F9 - Right hand, fifth digit • F7 - Right hand, third digit |
| Complexity Level | Moderate |
National average reimbursement for CPT 26433 by major payers:
$767.91
$733.23
$768.60
$954.16
| 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 26433 | ||||||
United | 26433 | $1233.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $821.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $575.00 | 1336721992 - HUNTSVILLE SURGERY CENTER LLC, LASER EYE SURGERY CENTER | 825435252 - (AL) HUNTSVILLE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $1451.00 | 1053565259 - SOUTHWEST LINCOLN SURGERY CENTER, LLC, SOUTHWEST LINCOLN SURGERY CENTER | 262981972 - (NE) SOUTHWEST LINCOLN SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $927.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $665.00 | 1427092279 - IPM SURGERY CENTERS LLC, SPINALCARE SURGICENTER | 330983021 - (CA) IPM SURGERY CENTERS, INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $800.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $991.00 | 1821485442 - ALLEGHENY HEALTH NETWORK SURGERY CENTER | 473690355 - (PA) ALLEGHENY HEALTH NETWORK SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $1276.00 | 1366559122 - HARVARD PARK SURGERY CENTER, LLC, HARVARD PARK SURGERY CENTER | 331107194 - (CO) HARVARD PARK SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $711.00 | 1164469086 - SAME DAY SURGICARE OF NEW ENGLAND, INC., SAME DAY SURGICLINIC | 42808359 - (MA) SAME DAY SURGICARE OF NEW ENGLAND, INC. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $1242.00 | 1740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC | 881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $1278.00 | 1881692036 - SAINT BARNABAS OUTPATIENT CENTERS, AMBULATORY SURGERY CENTER | 222458479 - (NJ) SAINT BARNABAS OUTPATIENT CENTERS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $1276.00 | 1811385883 - CENTRAL DELAWARE ENDOSCOPY UNIT LLC | 471840129 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $885.00 | 1871674481 - CAROLINAS PHYSICIANS NETWORK INC, ATRIUM HEALTH ENDOSCOPY CENTER BALLANTYNE | 561667838 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26433 | $555.00 | 1609568922 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | 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 26433 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26433 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 26433 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 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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