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See a sample rate comparisonCPT 26765 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, Open Treatment Of Distal Phalangeal Fracture Finger Or Thumb Includes Internal Fixation When Performed Each
| 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 F2 - Left hand, third digit F3 - Left hand, fourth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26765 |
| Medicaid Fee Schedule | View Medicaid rates for 26765 |
National average reimbursement for CPT 26765 by major payers:
$692.95
$647.06
$700.11
$812.16
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CPT 26765
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$7,081.00Published rateGolden Ridge Asc, LLC, Golden Ridge Surgery Center
$2,388.00Published rateLogan Surgical Suites LLC, Advanced Surgery Center Of Northern Utah
Logan Surgical Suites LLC
$1,570.00Published rateSouth Pointe Surgical Center
South Pointe Surgical Center, LLC
$1,000.00Published rateRiverside Ambulatory Surgery Center LLC
$475.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 26765 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26765 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 26765 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 |
|---|---|---|
| 26755-CPT | Moderate | Closed Treatment Of Distal Pha, Closed Treatment Of Distal Phalangeal Fracture Finger Orthumb With Manipulation Each Closed Treatment Of Distal Phalangeal Fracture Finger Or |
| 26756-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Distal Phalangealfracture Finger Or Thumb Each Percutaneous Skeletal Fixation Of Distal Phalangeal |
| 26765-CPT | Moderate | Treat Finger Fracture Each, Open Treatment Of Distal Phalangeal Fracture Finger Or Thumb Includes Internal Fixation When Performed Each |
| 26770-CPT | Moderate | Closed Treatment Of Interphala, Closed Treatment Of Interphalangeal Joint Dislocationsingle With Manipulation Without Anesthesia Closed Treatment Of Interphalangeal Joint Disloca Tion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26765. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26765 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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