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CPT 26516Medical Service

Repair of Joint Capsule of Hand and Palm 1 Finger

Repair of joint capsule of hand and palm, 1 finger. Clinical pricing breakdown and utilization metrics across 2 practicing doctors nationwide.

$2130.00
Peer Median Charge
Gross billed rate
$374.32
Standard Baseline
Customary allowable
5.7x
National Markup
Charge vs baseline
2
Active Physicians
Billing this code
Planning care or already received a bill for CPT 26516?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $2130.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $374.32 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code 26516 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"