CPT 26541 Fee Schedule
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.
| 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 • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26541 |
National average reimbursement for CPT 26541 by major payers:
$1,135.96
$1,095.47
$1,144.90
$1,398.44
| 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 26541 | ||||||
United | 26541 | $3570.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $3623.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $2050.00 | 1154322410 - SUMMIT SURGICAL SUITES, LLC, SOUTHWEST SURGICAL SUITES | 383641574 - (IN) SUMMIT SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $3623.00 | 1912378357 - DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $790.00 | 1083030597 - TRIAD SURGERY CENTER, LLC, TRIAD EYE INSTITUTE | 465002052 - (OK) TRIAD EYE INSTITUTE, PLLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $2878.00 | 1578515367 - BLACK CANYON SURGICAL CENTER, LLC | 510514274 - (CO) BLACK CANYON SURGICAL CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $3454.00 | 1073816690 - PENN STATE HERSHEY ENDOSCOPY CENTER LLC | 274000022 - (PA) PENN STATE HERSHEY ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $1430.00 | 1386670511 - HATTIESBURG AMBULATORY SURGERY CENTER LP, SOUTH MISSISSIPPI SURGERY CENTER | 752964475 - (MS) HATTIESBURG AMBULATORY SURGERY CENTER LP | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $1050.00 | 1497723720 - JACKSONVILLE BEACH SURGERY CENTER, LLC, JACKSONVILLE BEACH SURGERY CENTER | 621825684 - (FL) JACKSONVILLE BEACH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $648.00 | 1346386604 - DIGESTIVE HEALTH CENTER LLC | 341955920 - DIGESTIVE HEALTH CENTER, LTD. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $650.00 | 1093921298 - INDIANA SKIN CANCER AMBULATORY SURGICAL CENTER LLC | 260149227 - (IN) INDIANA SKIN CANCER AMBULATORY SURGICAL CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $6310.00 | 1477516979 - FAIRFAX SURGICAL CENTER, L.P. | 621861640 - (VA) FAIRFAX SURGICAL CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $2594.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $2982.00 | 1043684129 - UNIVERSITY OF MARYLAND MEDICINE ASC, LLC, UNIVERSITY OF MARYLAND SURGERY CENTER | 472525050 - (MD) UNIVERSITY OF MARYLAND MEDICINE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26541 | $1800.00 | 1811095136 - GROSSMONT OUTPATIENT SURGICAL CENTER | 953337109 - (CA) GROSSMONT OUTPATIENT SURGICAL CE | CA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 26541 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26541 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 26541 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 |
|---|---|---|
| 26535-CPT | Moderate | Arthroplasty I-P Joint |
| 26536-CPT | High | Arthroplasty I-P W Prosth Implant |
| 26540-CPT | Moderate | Reconstruct Collat Lig M-P Joint |
| 26541-CPT | High | Reconstruction, Collateral Ligament, Metacarpophalangeal Joint, Single; With Tendon Or Fascial Graft (Includes Obtaining Graft) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26541. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26541 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 26541) and we'll show you how you compare in 15 minutes or less.