CPT 26510 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 • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 26510 by major payers:
$862.26
$821.96
$860.23
$1,066.23
| 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 26510 | ||||||
United | 26510 | $2795.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $3570.00 | 1720325160 - SURGCENTER OF DEER VALLEY, LLC | 461512703 - (AZ) SURGCENTER OF DEER VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $1823.00 | 1932438553 - MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY | 263528303 - (CT) MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $3188.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $1387.00 | 1043612534 - HHC ASC, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $1319.00 | 1699429415 - ST LUKE'S SURGERY CENTER, LLC | 873243012 - A POSITIVE FOCUS COUNSELING LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $1983.00 | 1780218115 - SURGERY CENTER OF FORT WAYNE | 825163478 - (IN) SURGERY CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $576.00 | 1891127981 - PLAZA AMBULATORY SURGERY CENTER LLC | 352480914 - (OR) PLAZA AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $2771.00 | 1336437482 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $1079.00 | 1689679680 - TOSC, LLC, OSC-HMHP, LLC | 10724836 - (OH) THE ORTHOPAEDIC SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $2872.00 | 1083902423 - CHASKA PLAZA SURGERY CENTER, LLC, TWO TWELVE SURGERY CENTER | 450975783 - (MN) CHASKA PLAZA SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $3353.00 | 1639694797 - UCSD CENTER FOR SURGERY OF ENCINITAS, L.P. | 822326631 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $2880.00 | 1750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER | 364701304 - (TX) VIVERE HEALTH DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $576.00 | 1427134998 - HILL COUNTRY MEMORIAL SURGERY CENTER, LLC | 331039828 - (TX) HILL COUNTRY MEMORIAL SURGERY CE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26510 | $2375.00 | 1659113207 - WILMINGTON ASC LLC | 870883587 | NC | 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 26510 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26510 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 26510 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 |
|---|---|---|
| 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 |
| 26510-CPT | Moderate | Cross Intrinsic Transfer |
| 26516-CPT | High | Capsulodesis M-P Joint 1 Digit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26510. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26510 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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