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 |
| 11760 |
Repair of nail bed |
| 26011 |
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 |