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See a sample rate comparisonCPT 26497 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.
Restore Finger Movement, 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 Function Of The Fingers.
| 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 26497 |
| Medicaid Fee Schedule | View Medicaid rates for 26497 |
National average reimbursement for CPT 26497 by major payers:
$1,224.98
$1,180.21
$1,199.76
$1,473.95
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CPT 26497
5 of 25 sample ratesHigher to lower in this preview
Indianapolis Endoscopy Center LLP
$7,825.00Published rateArapahoe Endoscopy Center Partnership Pllp
$3,353.00Published ratePremier Surgery Center, LLC
Premier Surgery Center LLC
$2,248.00Published rateVero Beach Florida Asc LLC, Sebastian River Surgery Center
Vero Beach Florida Asc LLC
$1,349.00Published rateNew Berlin Medical Services, LLC
New Berlin Medical Services LLC
$1,142.00Published rate
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See a sample payer proposalCPT 26497 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26497 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 26497 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. |
| 26497-CPT | High | Restore Finger Movement, 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 Function Of The Fingers. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26497. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26497 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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