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See a sample rate comparisonCPT 26455 Fee Schedule
Last Verified: October 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.
Tenotomy Flexor Finger Open
| 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 59 - Distinct Procedural Service F7 - Right hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26455 |
| Medicaid Fee Schedule | View Medicaid rates for 26455 |
National average reimbursement for CPT 26455 by major payers:
$608.89
$558.60
$607.08
$731.63
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CPT 26455
5 of 25 sample ratesHigher to lower in this preview
North State Surgery Centers, Lp, Mercy Surgery Center
$2,989.00Published rateSurgical Elite Of Avondale, LLC
Surgical Elite Of Avondale LLC
$1,233.00Published rateOrthopedic South Surgical Partners, LLC, Orthopaedic South Surgical Center
Orthopedic South Surgical Partners LLC
$839.00Published rateNational Cardiovascular Surgery Center, LLC, Peak Surgery Center Of Avondale
National Cardiovascular Surgery Center LLC
$575.00Published rateMaryland Aesthetic And Reconstructive Ambulatory Surgical Center LLC
$283.00Published rate
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See a sample payer proposalCPT 26455 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26455 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 26455 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 |
|---|---|---|
| 26450-CPT | Moderate | Tenotomy, Flexor, Single, Palm, Open, Ea |
| 26455-CPT | Moderate | Tenotomy Flexor Finger Open |
| 26460-CPT | Moderate | Tenotomy Extensor Hand Or Fi, Tenotomy Extensor Hand Or Finger Open Each Tendontenotomy Extensor Hand Or Finger Open Each Tendon |
| 26471-CPT | Moderate | Tenodesis Pip Stabilization |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26455 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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