CPT 26502 Fee Schedule
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.
| 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 • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26502 |
National average reimbursement for CPT 26502 by major payers:
$978.21
$970.69
$1,006.70
$1,253.51
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 26502 | ||||||
United | 26502 | $702.00 | 1205800752 - MEDICAL EYE ASSOCIATES, INC. | 581606296 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1365.00 | 1003374711 - RIVERVIEW SURGICAL CENTER LLC | 821368525 - (NE) RIVERVIEW SURGICAL CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $2280.00 | 1437112455 - SPACE COAST SURGICAL CENTER LTD, MERRITT ISLAND SURGERY CENTER | 752516426 - (FL) SPACE COAST SURGICAL CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1889.00 | 1417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE | 412081861 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1882.00 | 1497314181 - OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC | 832118109 - (IL) OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1115.00 | 1164495198 - SARASOTA OPHTHALMOLOGY ASC LLC, CENTER FOR ADVANCED EYE SURGERY | 621825704 - (FL) SARASOTA OPHTHALMOLOGY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1464.00 | 1154481984 - SPRING VALLEY SURGERY CENTER, LLC | 880512805 - (NV) SPRING VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $6285.00 | 1992395388 - IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC, IU HEALTH SURGERY CENTER FORT WAYNE | 842206388 - (IN) IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $2100.00 | 1164946984 - NORTHWEST RENAL CLINIC, INC., NORTHWEST DIALYSIS ACCESS CENTER | 930751490 - (OR) NORTHWEST RENAL CLINIC, PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $300.00 | 1730355595 - FORT MYERS ENDOSCOPY CENTER LLC | 800149158 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $2273.00 | 1811940141 - SOUTHPARK SURGERY CENTER LLC, SOUTHPARK SURGERY CENTER | 870714098 - (NC) SOUTHPARK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1644.00 | 1619643608 - CARDIOVASCULAR ASC LLC | 462883732 - (FL) CARDIOVASCULAR ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1608.00 | 1093716037 - CATARACT AND REFRACTIVE SURGERY CENTER, LLC, NOVAMED SURGERY CENTER OF RICHMOND, LLC | 621865972 - (VA) CATARACT AND REFRACTIVE SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1131.00 | 1255303517 - ST DOMINIC AMBULATORY SURGERY CENTER L L C | 640908713 - (MS) ST DOMINIC AMBULATORY SURGERY CENTER L L C | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26502 | $1575.00 | 1225023021 - ARC OF GEORGIA, LLC, PREMIER SURGERY CENTER | 621746313 - (GA) ARC OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 26502 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26502 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 26502 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 |
|---|---|---|
| 26498-CPT | High | Tendon Txfer-Restore Intrin.Func; All 4 |
| 26500-CPT | Moderate | Tendon Pulley Reconstruction;W Local Tis |
| 26502-CPT | Moderate | Reconstruction Of Tendon Pulley, Each Tendon; With Tendon Or Fascial Graft (Includes Obtaining Graft) (Separate Procedure) |
| 26508-CPT | Moderate | Release Thenar Muscle For Contract |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26502. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26502 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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