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See a sample rate comparisonCPT 26434 Fee Schedule
Last Verified: September 2026
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.
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
| 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 F2 - Left hand, third digit RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26434 |
| Medicaid Fee Schedule | View Medicaid rates for 26434 |
National average reimbursement for CPT 26434 by major payers:
$949.72
$886.98
$925.23
$1,126.41
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CPT 26434
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Fort Worth
Texas Health Harris Methodist Hospital Southwest Fort Worth
$9,098.00Published rateTamarac Surgery Center LLC, The Surgery Center Of Ft Lauderdale
Tamarac Surgery Center LLC
$3,623.00Published rateBanner Peoria Surgery Center LLC
$2,855.00Published rateAsc Development Company, LLC, National Spine And Pain Centers
Asc Development Company LLC
$1,763.00Published rateCentral Ohio Urology Surgery Center, LLC
Central Ohio Urology Surgery Center LLC
$1,056.00Published rate
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See a sample payer proposalCPT 26434 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26434 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 26434 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 26434. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26434 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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