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See a sample rate comparisonHealthcare 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 |
| Medicaid Fee Schedule | View Medicaid rates for 26541 |
National average reimbursement for CPT 26541 by major payers:

$1,135.96

$1,095.47

$1,144.90

$1,367.86
Choose a payer to see a sample of rates for CPT 26541.
Fairfax Surgical Center Lp
University Of Maryland Medicine Asc LLC
Summit Surgical Suites LLC
Iec Surgical Centers LLC
Digestive Health Center, Ltd.
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 |
|---|---|---|
| 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 |
| 26541-CPT | High | Reconstruct Hand Ligament, Surgery To Reconstruct A Collateral Ligament Of The Hand Or Finger Using A Graft. These Ligaments Help Stabilize The Bones When The Hand Or Finger Moves From Side-To-Side. |
| 26542-CPT | Moderate | Reconstruct Hand Ligament, Surgery To Reconstruct A Collateral Ligament Of The Hand Or Finger Using A Graft. These Ligaments Help Stabilize The Bones When The Hand Or Finger Moves From Side-To-Side. |
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.
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