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See a sample rate comparisonCPT 26742 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 Articular Fracture Involving Metacarpophalangeal Or Interphalangeal Joint With Manipulation Each
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 24 - Ambulatory Surgical Center |
| Common Modifiers | None F4 - Left hand, fifth digit F9 - Right hand, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26742 |
| Medicaid Fee Schedule | View Medicaid rates for 26742 |
National average reimbursement for CPT 26742 by major payers:
$520.77
$493.54
$520.35
$632.36
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CPT 26742
5 of 25 sample ratesHigher to lower in this preview
Silicon Valley Surgery Center, Lp
Silicon Valley Surgery Center, L.P.
$2,830.00Published rateSurgicare Of Miramar LLC
$574.00Published rateAllina Health Surgery Center- Vadnais Heights LLC
Allina Health Surgery Center Vadnais Heights LLC
$301.00Published rateBlue Ridge Surgical Center, LLC
Blue Ridge Surgical Center LLC
$124.00Published rateWinter Haven-Sebring Fl Ophthalmology Asc LLC, Eye Surgery & Laser Center Of Sebring
$50.00Published rate
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See a sample payer proposalCPT 26742 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26742 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 26742 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 |
|---|---|---|
| 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 |
| 26742-CPT | Moderate | Treat Finger Fracture Each, Closed Treatment Of Articular Fracture Involving Metacarpophalangeal Or Interphalangeal Joint With 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 26742. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26742 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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