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See a sample rate comparisonCPT 26820 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Fuse Thumb Joint Together, Surgery To Fuse The Thumb In Opposition. Opposition Means Movement Toward The Palm Of The Hand. Fusing The Thumb Joint Relieves Pain From The Bones Moving.
| 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 LT - Left side of body F5 - Right hand, thumb |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 26820 |
| Medicaid Fee Schedule | View Medicaid rates for 26820 |
National average reimbursement for CPT 26820 by major payers:
$1,175.19
$1,077.02
$1,109.66
$1,351.06
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CPT 26820
5 of 25 sample ratesHigher to lower in this preview
Center For Ambulatory Surgery, LLC, The Center For Ambulatory Surgery
The Center For Ambulatory Surgery LLC
$5,015.00Published rateSurgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$3,500.00Published rateTampa Bay Surgery Center Associates,Ltd
Tampa Bay Surgery Center Assoc
$2,200.00Published rateAthens Surgery Center LLC, The Surgery Center Of Athens
$1,352.00Published ratePremier Endoscopy Center,LLC
$383.00Published rate
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See a sample payer proposalCPT 26820 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26820 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 26820 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 |
|---|---|---|
| 26775-CPT | Moderate | Closed Treatment Of Interphala, Closed Treatment Of Interphalangeal Joint Dislocationsingle With Manipulation Requiring Anesthesia Closed Treatment Of Interphalangeal Joint Dislocation |
| 26776-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Interphalangeal Jointdislocation Single With Manipulation Percutaneous Skeletal Fixation Of Interphalangeal Joint |
| 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. |
| 26820-CPT | High | Fuse Thumb Joint Together, Surgery To Fuse The Thumb In Opposition. Opposition Means Movement Toward The Palm Of The Hand. Fusing The Thumb Joint Relieves Pain From The Bones Moving. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26820 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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