CPT 26910 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • F6 - Right hand, second digit • F1 - Left hand, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26910 |
National average reimbursement for CPT 26910 by major payers:
$998.88
$980.85
$1,053.54
$1,262.36
| 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 26910 | ||||||
United | 26910 | $5310.00 | 1669701157 - GLASTONBURY SURGERY CENTER, LLC | 262600828 - (CT) GLASTONBURY SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $673.00 | 1386885556 - THE ASC AT WAUGH CHAPEL | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $6285.00 | 1306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER | 271497960 - (IN) ROC SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $1500.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $1583.00 | 1962668319 - BOULDER MEDICAL CENTER, PC, BOULDER MEDICAL CENTER ASC | 840834835 - BOULDER MEDICAL CENTER, P.C. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $2100.00 | 1366065674 - SOUTH DENVER SURGICAL SERVICES LLC, SOUTH DENVER UROLOGY CENTER | 850873977 - (CO) SOUTH DENVER SURGICAL SERVICES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $2847.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $1335.00 | 1801073648 - ELITE ENDOSCOPY LLC | 202722461 - (NV) ELITE ENDOSCOPY LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $3347.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $3570.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $6734.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $935.00 | 1669437497 - CASCADE SURGICENTER, LLC | 731677879 - (OR) CASCADE SURGICENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $935.00 | 1639682503 - SOUTH PLAINS SURGERY CENTER LLC | 822142398 - (TX) SOUTH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $3500.00 | 1750922142 - DERRY SURGICAL CENTER, LLC | 821436601 - (NH) DERRY SURGICAL CENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 26910 | $1600.00 | 1447991138 - SILVER STATE SURGERY CENTER WEST LLC | 872764352 - (NV) SILVER STATE SURGERY CENTER WEST LLC | NV | 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 26910 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26910 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 26910 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 |
|---|---|---|
| 26860-CPT | Moderate | Arthrodesis,Interphalangeal Joint,W/Wo I |
| 26861-CPT | Low | Arthrodesis, Interphalangeal Joint, With Or Without Internal Fixation; Each Additional Interphalangeal Joint (List Separately In Addition To Code For Primary Procedure) |
| 26862-CPT | High | Arthrodesis,Interphalan.Joint,W/Wo Fix;W |
| 26910-CPT | Moderate | Amputation Metacarpal W Finger/Thumb,1,W |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26910. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26910 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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