Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 26496 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.
Opponens Plasty Other Methods
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26496 |
| Medicaid Fee Schedule | View Medicaid rates for 26496 |
National average reimbursement for CPT 26496 by major payers:
$1,206.23
$1,168.19
$1,213.63
$1,469.71
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 26496.
CPT 26496
5 of 25 sample ratesHigher to lower in this preview
St. Clair Memorial Hospital
St Clair Health Corporation
$9,811.65Published rateHouston Urologic Surgicenter, LLC
$2,675.00Published rateCleburne Endoscopy Center, LLC
Cleburne Endoscopy Center LLC
$2,010.00Published rateMethodist Surgery Center Germantown Lp
$1,461.00Published rateBaywood Medical Associates, PLLC, Desert Pain Institute - Asc
Baywood Medical Associates, PLLC Dba Desert Pain Institute
$736.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 26496 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26496 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 26496 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 |
|---|---|---|
| 26490-CPT | High | Opponensplasty; Superficialis Tndon Trnsfer Typ Ea Tndon, Opponensplasty; Superficialis Tendon Transfer Type Each Tendon |
| 26492-CPT | High | Opponensplasty; Tndon Trnsfer W/ Grft (Inclu Obtain Grft), Opponensplasty; Tendon Transfer With Graft (Includes Obtaining Graft) |
| 26494-CPT | High | Move Tendon For Hand Function, A Functioning Muscle Is Moved From Its Original Attachment To A New One. The Procedure Is Done To Improve Lost Hand Function. |
| 26496-CPT | High | Opponens Plasty Other Methods |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26496. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26496 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 26496) and we'll show you how you compare in 15 minutes or less.