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See a sample rate comparisonCPT 26685 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.
Open Treatment Of Carpometacar, Open Treatment Of Carpometacarpal Dislocation Other Than Thumb Includes Internal Fixation When Performed Each Joint
| 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 F9 - Right hand, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26685 |
| Medicaid Fee Schedule | View Medicaid rates for 26685 |
National average reimbursement for CPT 26685 by major payers:
$744.26
$767.11
$777.14
$949.35
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CPT 26685
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Pinecroft, LLC
Memorial Hermann Surgery Center Pinecroft LLC
$5,729.00Published rateLakeside Endoscopy Center LLC
Lakeside Endoscopy Center, LLC
$2,702.00Published rateAdvanced Surgery Center, LLC
$1,615.00Published rateDoctors Outpatient Surgery Center LLC, Surgery Center
Doctors Outpatient Surgery Center LLC
$1,232.00Published rateGynemed Surgical Center
$465.00Published rate
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See a sample payer proposalCPT 26685 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26685 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 26685 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 | Closed Treatment Of Carpometac, Closed Treatment Of Carpometacarpal Dislocation Thumb Withmanipulation Closed Treatment Of Carpometacarpal Dislocation Thumb With |
| 26645-CPT | Moderate | Closed Treatment Of Carpometac, Closed Treatment Of Carpometacarpal Fracture Dislocationthumb (Bennett Fracture) With Manipulationclosed Treatment Of Carpometacarpal Fracture Dis Location |
| 26665-CPT | Moderate | Surgery For Broken Thumb, Surgery To Correct A Broken And Dislocated Joint In The Thumb. Pins Wires Or Screws May Be Used To Hold The Bones In Place. A Splint Is Applied To The Hand. |
| 26685-CPT | Moderate | Open Treatment Of Carpometacar, Open Treatment Of Carpometacarpal Dislocation Other Than Thumb Includes Internal Fixation When Performed Each Joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26685 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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