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CPT 26756 Fee Schedule

Last Verified: December 2025

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.

Red Fx-Phalanx Distal W Pinning
Key FactDetail
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

F3 - Left hand, fourth digit

F9 - Right hand, fifth digit

Complexity LevelModerate

National average reimbursement for CPT 26756 by major payers:

bcbs

$589.78

uhc

$561.73

aetna

$588.44

cigna

$717.27

Preview provider-level rates for...
For billing codeCPT 26756
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 26756

United
26756$2169.001932162195 - COVENANT HIGH PLAINS SURGERY CENTER, LLC, COVENANT HIGH PLAINS SURGERY CENTER - QUAKER AVENUE752177401 - (TX) COVENANT HIGH PLAINS SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1518.001134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1343.001558720235 - DHCH LLC811030907 - (NY) DHCH, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1696.001437601200 - UROPARTNERS SURGERY CENTER, LLC814131096 - (IL) UROPARTNERS SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1450.001841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERYMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$815.001952602609 - GASTROENTEROLOGY & HEPATOLOGY CONSULTANTS, PA, WAKE FOREST ENDOSCOPY CENTER562189630 - (NC) GASTROENTEROLOGY AND HEPATOLOGY CONSULTANTS, P.A.NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2307.001427152073 - PATIENT PARTNERS LLC201400198 - (TN) PATIENT PARTNERS LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$4781.001154454205 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLETXAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2200.001891882031 - GARDEN STATE SURGICAL CENTER, LLC223420171 - (NJ) GARDEN STATE SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1145.001225107014 - COMMONWEALTH EYE CLINIC INC611140257 - (KY) COMMONWEALTH EYE CLINIC INCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2388.001538609011 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY - SOUTHSIDE384016302FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$1421.001497733661 - CHEVY CHASE AMBULATORY CENTER LP432003978 - (CA) CHEVY CHASE AMBULATORY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2285.001083715148 - ASC SURGICAL VENTURES, LLC, OSMC OUTPATIENT SURGERY CENTER351995261INAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2284.001063453561 - TEMPLETON SURGERY CENTER, LLC, TEMPLETON SURGERY CENTER202246616 - (CA) TEMPLETON SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
26756$2615.001750376836 - ST. PETER'S AMBULATORY SURGERY CENTER LLC, ST. PETER'S SURGERY & ENDOSCOPY CENTER460463892 - (NY) ST. PETER'S AMBULATORY SURGERY CENTER, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 26756 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 26756 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 26756 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.

CodeComplexityDescription
26750-CPTModerateTreat Fx-Phalanx Distal
26755-CPTModerateRed Fx-Phalanx Distal
26756-CPTModerateRed Fx-Phalanx Distal W Pinning
26765-CPTModerateRed Fx Open-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 26756. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 26756 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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