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See a sample rate comparisonCPT 26725 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.
Treat Finger Fracture Each, Closed Treatment Of Phalangeal Shaft Fracture Proximal Or Middle Phalanx Finger Or Thumb With Manipulation With Or Without Skin Or Skeletal Traction Each
| 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 26725 |
| Medicaid Fee Schedule | View Medicaid rates for 26725 |
National average reimbursement for CPT 26725 by major payers:
$452.33
$449.58
$493.53
$557.46
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CPT 26725
5 of 25 sample ratesHigher to lower in this preview
Texas Endoscopy Centers, LLC, Texas Endoscopy
$1,446.00Published rateFoothills Surgery Center, LLC
$506.00Published rateNorthern Arizona Surgicenter, LLC
Northern Arizona Surgicenter LLC
$275.00Published rateMinimally Invasive Surgical And Neuroscience LLC, Delaware Outpatient Center For Surgery
Delaware Outpatient Center For Surgery
$113.00Published ratePresence Lakeshore Gastroenterology, LLC
Presence Lakeshore Gastroenterology LLC Dba Des Plaines Endoscopy Cent
$50.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 26725 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26725 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 26725 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 |
| 26725-CPT | Moderate | Treat Finger Fracture Each, Closed Treatment Of Phalangeal Shaft Fracture Proximal Or Middle Phalanx Finger Or Thumb With Manipulation With Or Without Skin Or Skeletal Traction Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26725. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26725 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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