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See a sample rate comparisonCPT 26785 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.
Surgery On Dislocated Finger, Surgery To Correct A Dislocated Finger Joint. Pins Wires Or Screws May Be Used To Hold The Bones In Place. A Splint Is Applied To The Hand.
| 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 26785 |
| Medicaid Fee Schedule | View Medicaid rates for 26785 |
National average reimbursement for CPT 26785 by major payers:
$685.12
$701.66
$740.74
$879.58
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CPT 26785
5 of 25 sample ratesHigher to lower in this preview
El Paso Surgery Centers Lp
$6,259.00Published rateNorthwest Georgia Orthopaedic Surgery Center, LLC
Northwest Georgia Orthopaedic Surgery Center LLC
$2,388.00Published rateSurgcenter Northern Phoenix LLC
$1,713.00Published rateAtlanta General And Bariatric Surgery Center, LLC
Atlanta General And Bariatric
$1,184.00Published rateSal Blake
Deaconess Hospital Inc
$438.45Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 26785 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26785 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 26785 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 |
|---|---|---|
| 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 |
| 26775-CPT | Moderate | Closed Treatment Of Interphala, Closed Treatment Of Interphalangeal Joint Dislocationsingle With Manipulation Requiring Anesthesia Closed Treatment Of Interphalangeal Joint Dislocation |
| 26785-CPT | Moderate | Surgery On Dislocated Finger, Surgery To Correct A Dislocated Finger Joint. Pins Wires Or Screws May Be Used To Hold The Bones In Place. A Splint Is Applied To The Hand. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26785 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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