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See a sample rate comparisonCPT 26720 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.
Closed Treatment Of Phalangeal, Closed Treatment Of Phalangeal Shaft Fracture Proximal Ormiddle Phalanx Finger Or Thumb Without Manipulation Each Closed Treatment Of Phalangealshaft Fracture Proximal Or
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | None 54 - Surgical Care Only F4 - Left hand, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26720 |
| Medicaid Fee Schedule | View Medicaid rates for 26720 |
National average reimbursement for CPT 26720 by major payers:
$276.18
$259.52
$288.25
$321.89
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CPT 26720
5 of 25 sample ratesHigher to lower in this preview
Columbia Eye And Specialty Surgery Center Ltd
$2,965.00Published rateSurgery Center At University Park, LLC, Premier Surgery Center Of Sarasota
Surgery Center At University Park LLC
$531.00Published rateHirak Sen
Deaconess Hospital Inc
$344.14Published rateJoint Replacement Center Of Louisiana
Joint Replacement Center Of Lous
$113.00Published rateUrology Specialists Surgery Center, LLC
Urology Specialists Surgery Center LLC
$81.00Published rate
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See a sample payer proposalCPT 26720 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26720 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 26720 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 |
|---|---|---|
| 26700-CPT | Moderate | Closed Treatment Of Metacarpop, Closed Treatment Of Metacarpophalangeal Dislocation Singlewith Manipulation Without Anesthesia Closed Treatment Of Metacarpophalangeal Dislocation Single |
| 26705-CPT | Moderate | Closed Treatment Of Metacarpop, Closed Treatment Of Metacarpophalangeal Dislocation Singlewith Manipulation Requiring Anesthesia Closed Treatment Of Metacarpophalangeal Dislocati On Single |
| 26706-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Metacarpophalangealdislocation Single With Manipulation Percutaneous Skeletal Fixation Of Metacarpophalangeal |
| 26720-CPT | Moderate | Closed Treatment Of Phalangeal, Closed Treatment Of Phalangeal Shaft Fracture Proximal Ormiddle Phalanx Finger Or Thumb Without Manipulation Each Closed Treatment Of Phalangealshaft Fracture Proximal Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26720 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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