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See a sample rate comparisonHealthcare 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 F4 - Left hand, fifth digit F9 - Right hand, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26727 |
| Medicaid Fee Schedule | View Medicaid rates for 26727 |
National average reimbursement for CPT 26727 by major payers:

$680.60

$631.31

$679.20

$784.13
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Holly Springs Surgery Center LLC
Deaconess Hospital Inc
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 26727 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26727 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 26727 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 |
|---|---|---|
| 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 |
| 26727-CPT | Moderate | Treat Finger Fracture Each, Percutaneous Skeletal Fixation Of Unstable Phalangeal Shaft Fracture Proximal Or Middle Phalanx Finger Or Thumb With Manipulation Each |
| 26735-CPT | Moderate | Treat Finger Fracture Each, Open Treatment Of Phalangeal Shaft Fracture Proximal Or Middle Phalanx Finger Or Thumb Includes Internal Fixation When Performed Each |
| 26740-CPT | Moderate | Treat Finger Fracture Each, Closed Treatment Of Articular Fracture Involving Metacarpophalangeal Or Interphalangeal Joint Without Manipulation Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26727. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26727 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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