We’re increasing our physician fee schedule for certain hand surgery procedures when performed in an office-based setting beginning July 1, 2021

We're committed to helping your patients get the right care, at the right time, in the right place, and at the right price. That's why it's important for us to do periodic review of our fee schedule. Based on our recent review we are increasing the fees for certain CPT codes when performed in an office-based setting, effective with dates of service on or after July 1, 2021.

Why we're increasing the fee schedule

When services can be performed in an office-based setting instead of a hospital or surgery center, your patients may save money and have fewer out-of-pocket costs. About 60% of Priority Health members have a $1,000 or higher deductible, which means their out-of-pocket costs may be higher if the procedure is performed in a location other than an office-based setting. Studies have found that patients with high deductible plans delay or avoid necessary care, so choosing a lower-cost option could help your patients get the care they need.

View your fee schedule to see the changes made to this list of CPT codes.

Review the full list of codes below.

CPT Description
20680 Removal of support implant
25075 Under excision procedures on the forearm and wrist
Repair of nail bed
Drainage of finger abscess
25624 Treat wrist bone fracture
20525 Removal of foreign body
25028 Drainage of forearm lesion
25031 Drainage of forearm bursa
25040 Explore/treat wrist joint
26075 Explore/treat finder joint
26776 Pin finger dislocation
26785 Treat finder dislocation
24359 Under repair, revision, and/or reconstruction procedures on the humerus and elbow
25390 Shorten radius or ulna
25607 Under fracture and/or dislocation procedures on the forearm and wrist
25609 Under fracture and/or dislocation procedures on the forearm and wrist
25628 Treat wrist bone fracture
25645 Treat wrist bone fracture
26356 Repair finger/hand tendon
26480 Transplant hand tendon
26531 Revise knuckle with implant
26536 Revise/implant finger joint
26540 Repair hand joint
26608 Treat metacarpal fracture
26615 Treat metacarpal fracture
26735 Treat finder fracture each
26860 Fusion of finger joint
29846 Wrist arthroscopy/surgery
29848 Wrist endoscopy/surgery
64718 Revise ulnar nerve at elbow
64719 Revise ulnar nerve at wrist