CPT 26665 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 • F5 - Right hand, thumb |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26665 |
National average reimbursement for CPT 26665 by major payers:
$865.43
$833.07
$862.59
$1,056.53
| 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 26665 | ||||||
United | 26665 | $5414.08 | 1699252395 - LINDUSTRIES, LLC, SEVENTH AVENUE SURGERY CENTER | 825145499 - (NE) LINDUSTRIES LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $3000.00 | 1154873594 - AMERICAN ACCESS CARE OF PENNSYLVANIA ASC LLC | 814056190 - (PA) AMERICAN ACCESS CARE OF PENNSYLVANIA ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $4000.00 | 1154400471 - ST. LOUIS WOMEN'S SURGERY CENTER, LLC, ST. LOUIS MULTISPECIALTY SURGERY CENTER | 680526281 - (MO) ST LOUIS WOMENS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $501.89 | 1861134314 - BAILEY RANKIN | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 26665 | $3566.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $501.89 | 1821721739 - CAROLYN COLE | 350593390 - DEACONESS HOSPITAL INC | IN | Medical Physician Assistant (363AM0700X) |
United | 26665 | $1760.00 | 1962031807 - CVP SURGERY CENTER IVY POINTE, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $6087.00 | 1861905176 - BERKSHIRE EYE, LLC | 352609003 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $9793.00 | 1114260254 - SPRING HILL SURGERY CENTER, LLC | 462325870 - (TN) SPRING HILL SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $819.00 | 1669772893 - ADVANCED EYE SURGERY CENTER, L.L.C. | 273717607 - (KS) ADVANCED EYE SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $6492.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $576.00 | 1861504037 - BOULEVARD SURGICENTER, INC. | 203112450 - (CA) BOULEVARD SURGICENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $4034.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $3943.00 | 1609400290 - ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | 844818321 - (TX) ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26665 | $2793.00 | 1710151063 - HENDI AMBULATORY SURGERY CENTER, PC | 262238944 - (MD) HENDI AMBULATORY SURGERY CENTER PC | MD | 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 26665 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26665 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 26665 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 |
|---|---|---|
| 26641-CPT | Moderate | Close Carpometacarpal Dis W Manip |
| 26645-CPT | Moderate | Red Fx-Bennett |
| 26650-CPT | Moderate | Perc Fix Carpometacarpal Fract Thmb |
| 26665-CPT | Moderate | Open Treatment Of Carpometacarpal Fracture Dislocation, Thumb (Bennett Fracture), Includes Internal Fixation, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26665. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26665 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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