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See a sample rate comparisonCPT 26485 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery On Tendon In Hand, A Functioning Tendon Is Detached From Its Original Insertion Onto Bone And Re-Sewn Onto A Different Bone Or Tendon. The Procedure Is Done To Improve Lost Hand Function.
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26485 |
| Medicaid Fee Schedule | View Medicaid rates for 26485 |
National average reimbursement for CPT 26485 by major payers:
$1,175.87
$1,105.40
$1,141.02
$1,441.56
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CPT 26485
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes South Surgery Center LLC
$6,623.00Published rateProvidence Surgery And Procedure Center LLC
$3,354.00Published rateThe Arcadia Ca Endoscopy Asc Lp, Valley Digestive Health Center
$2,060.00Published rateClermont Ambulatory Surgical Center
$1,400.00Published rateTennessee Pain Surgery Center, LLC
Tennessee Pain Surgery Center LLC
$724.00Published rate
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See a sample payer proposalCPT 26485 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26485 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 26485 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 |
|---|---|---|
| 26480-CPT | High | Surgery On Tendon In Hand, A Functioning Tendon Is Detached From Its Original Insertion Onto Bone And Re-Sewn Onto A Different Bone Or Tendon. The Procedure Is Done To Improve Lost Hand Function. |
| 26483-CPT | High | Surgery On Tendon In Hand, A Functioning Tendon Is Detached From Its Original Insertion Onto Bone And Re-Sewn Onto A Different Bone Or Tendon. The Procedure Is Done To Improve Lost Hand Function. |
| 26485-CPT | High | Surgery On Tendon In Hand, A Functioning Tendon Is Detached From Its Original Insertion Onto Bone And Re-Sewn Onto A Different Bone Or Tendon. The Procedure Is Done To Improve Lost Hand Function. |
| 26489-CPT | High | Surgery On Tendon In Hand, A Functioning Tendon Is Detached From Its Original Insertion Onto Bone And Re-Sewn Onto A Different Bone Or Tendon. The Procedure Is Done To Improve Lost Hand Function. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26485. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26485 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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