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See a sample rate comparisonCPT 26554 Fee Schedule
Last Verified: October 2026
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.
Transfer Toe-To-Hand With Mic, Transfer Toe-To-Hand With Microvascular Anastomosis Other Than Great Toe Double Transfer Toe-To-Hand With Microvascular Anastomosis Other
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 19 - Off Campus Outpatient Hospital 22 - On Campus Outpatient Hospital 23 - Emergency Room 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body T4 - Left foot, fifth digit F1 - Left hand, second digit T3 - Left foot, fourth digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26554 |
| Medicaid Fee Schedule | View Medicaid rates for 26554 |
National average reimbursement for CPT 26554 by major payers:
$5,127.00
$4,989.79
$4,998.67
$6,044.96
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CPT 26554
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$11,972.00Published rateWisconsin Specialty Surgery Center,LLC
Wisconsin Specialty Surgery Center LLC
$5,249.00Published rateSurgery Center Of Munster, LLC, The Center For Minimally Invasive Surgery
Surgery Center Of Munster LLC
$3,300.00Published rateLoveland Endoscopy Center, LLC, Skyline Endoscopy Center
Loveland Endoscopy Center LLC
$2,112.00Published rateMountain West Derm
$766.00Published rate
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See a sample payer proposalCPT 26554 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26554 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 26554 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 |
|---|---|---|
| 26553-CPT | High | Transfer Toe-To-Hand With Mic, Transfer Toe-To-Hand With Microvascular Anastomosis Other Than Great Toe Single Transfer Toe-To-Hand With Microvascular Anastomosis Other |
| 26554-CPT | High | Transfer Toe-To-Hand With Mic, Transfer Toe-To-Hand With Microvascular Anastomosis Other Than Great Toe Double Transfer Toe-To-Hand With Microvascular Anastomosis Other |
| 26556-CPT | High | Free Toe Joint Transfer With Microvascular Anastomosis |
| 26565-CPT | Moderate | Osteotomy Metacarpal Deformity |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26554 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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