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See a sample rate comparisonCPT 26540 Fee Schedule
Last Verified: October 2026
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.
Rpair Of Collateral Ligamnt Metacarpophalang Or Interphalang, Repair Of Collateral Ligament Metacarpophalangeal Or Interphalangeal
| 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 F5 - Right hand, thumb FA - Left hand, thumb |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26540 |
| Medicaid Fee Schedule | View Medicaid rates for 26540 |
National average reimbursement for CPT 26540 by major payers:
$967.66
$904.23
$979.37
$1,142.22
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CPT 26540
5 of 25 sample ratesHigher to lower in this preview
Advanced Surgery Center Of Lancaster, LLC
Advanced Surgery Center Of Lancaster LLC
$3,145.00Published rateVermont Eye Surgery & Laser Center
Vermont Eye Surgery & Laser Center, LLC 401(K) Plan
$1,245.00Published rateWinter Park Surgery Center Lp, Physician'S Surgical Care Center
Winter Park Surgery Center Lp
$840.00Published rateAlderwood Surgery Center LLC, Seattle Plastic Surgery Center
Robert M. Grenley, M.D., P.S.
$624.00Published rateSuncoast Surgery Center, LLC
$400.00Published rate
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See a sample payer proposalCPT 26540 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26540 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 26540 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 |
|---|---|---|
| 26531-CPT | Moderate | Arthroplst Metacarpophalang Joint; W/ Prosthet Implnt Ea, Arthroplasty Metacarpophalangeal Joint; With Prosthetic Implant Each |
| 26535-CPT | Moderate | Arthroplasty I-P Joint |
| 26536-CPT | High | Arthroplst Interphalang Joint; W/ Prosthet Implnt Ea Joi, Arthroplasty Interphalangeal Joint; With Prosthetic Implant Each Joi |
| 26540-CPT | Moderate | Rpair Of Collateral Ligamnt Metacarpophalang Or Interphalang, Repair Of Collateral Ligament Metacarpophalangeal Or Interphalangeal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26540 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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