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See a sample rate comparisonCPT 26990 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.
Drain Pelvis Or Hip Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Pelvis Or Hip.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26990 |
| Medicaid Fee Schedule | View Medicaid rates for 26990 |
National average reimbursement for CPT 26990 by major payers:
$828.35
$864.83
$925.57
$1,072.38
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CPT 26990
5 of 25 sample ratesHigher to lower in this preview
Bristol Surgery Center, LLC
$2,859.00Published rateAllina Health Surgery Center
$2,046.00Published rateMt Laurel Endoscopy Center L P
$1,469.00Published rateWilmington Gastroenterology Endoscopy Center, Inc
Wilmington Gastroenterology Endoscopy Center Inc
$1,150.00Published rate9106 Philadelphia Road Ambulatory Surgery Center LLC
$638.00Published rate
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See a sample payer proposalCPT 26990 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26990 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 26990 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 |
|---|---|---|
| 26990-CPT | Moderate | Drain Pelvis Or Hip Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Pelvis Or Hip. |
| 26991-CPT | Moderate | Drain Pelvis Or Hip Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Pelvis Or Hip. |
| 26992-CPT | High | Ncision Bone Cortex Pelvis &/Or Hip Joint (Eg Osteomyeli, Incision Bone Cortex Pelvis And/Or Hip Joint (Eg Osteomyelitis Or B |
| 27000-CPT | Moderate | Tenotomy Adductor Hip Subcut Closed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26990. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26990 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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