CPT 26750 Fee Schedule
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.
| 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 • F2 - Left hand, third digit |
| Complexity Level | Moderate |
National average reimbursement for CPT 26750 by major payers:
$261.28
$243.66
$267.55
$317.93
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 26750 | ||||||
United | 26750 | $1070.00 | 1629249172 - NORTH STATE SURGERY CENTERS LP, COURT STREET SURGERY CENTER | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $531.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $178.00 | 1194083824 - PROVIDENCE FACEY MEDICAL FOUNDATION, FACEY ENDOSCOPY CENTER | 954322584 - (CA) PROVIDENCE FACEY MEDICAL FOUNDATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $1029.00 | 1851650428 - TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE | 822296081 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $126.00 | 1861449571 - KIRURGS, LLC, SURGEONS' SURGICAL CENTER | 522018568 - (MD) SURGEONS SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $200.00 | 1255676920 - NORTHPOINTE SURGICAL CENTER, LLC | 461487986 - (UT) NORTHPOINTE SURGICAL CENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $555.00 | 1154323988 - CENTRAL VIRGINIA SURGI-CENTER LP, SURGI-CENTER OF CENTRAL VIRGINIA | 752967162 - (VA) CENTRAL VIRGINIA SURGICENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $247.00 | 1336107580 - POMERADO OUTPATIENT SURGICAL CENTER L P, PALOMAR SURGICAL CENTER ESCONDIDO | 330752699 - (CA) POMERADO OUTPATIENT SURGICAL CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $77.00 | 1205925278 - LUDWICK LASER & SURGERY CENTER, LLC | 205159711 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $82.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $555.00 | 1124125604 - MURDOCK AMBULATORY SURGERY CENTER LLC | 201543128 - (FL) MURDOCK AMBULATORY SURGERY CENTE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $198.00 | 1871536763 - ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD., ROCKFORD ENDOSCOPY CENTER | 363081482 - (IL) ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $321.67 | 1811459217 - MEGAN HORNYAK | 350593390 - DEACONESS HOSPITAL INC | WV | Certified Registered Nurse Anesthetist (367500000X) |
United | 26750 | $528.00 | 1811262363 - PRECISION SURGERY CENTER, LLC | 453655088 - (KS) PRECISION SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26750 | $574.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 26750 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26750 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 26750 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 |
|---|---|---|
| 26735-CPT | Moderate | Open Treatment Of Phalangeal Shaft Fracture, Proximal Or Middle Phalanx, Finger Or Thumb, Includes Internal Fixation, When Performed, Each |
| 26746-CPT | Moderate | Open Treatment Of Articular Fracture, Involving Metacarpophalangeal Or Interphalangeal Joint, Includes Internal Fixation, When Performed, Each |
| 26750-CPT | Moderate | Treat Fx-Phalanx Distal |
| 26755-CPT | Moderate | Red Fx-Phalanx Distal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26750 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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