Cost analysis for CPT 26055 — Incision of tendon covering of finger
Average Medicare Payment
$280.98
2023 data
Total Payments (2023)
$35.1M
Services (2023)
117.3K
Price Change (2014–2023)
+3.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $271.28 | $22.4M | 79.5K | — |
| 2015 | $265.08 | $23.9M | 86.2K | -2.3% |
| 2016 | $300.99 | $30.3M | 93.6K | +13.5% |
| 2017 | $269.10 | $27.5M | 97.0K | -10.6% |
| 2018 | $276.01 | $31.2M | 106.2K | +2.6% |
| 2019 | $274.12 | $32.9M | 113.3K | -0.7% |
| 2020 | $271.94 | $28.4M | 98.2K | -0.8% |
| 2021 | $278.88 | $33.0M | 111.5K | +2.6% |
| 2022 | $279.96 | $33.6M | 112.5K | +0.4% |
| 2023 | $280.98 | $35.1M | 117.3K | +0.4% |
The most expensive state pays 2.7x more than the cheapest for this procedure. AK averages $438.54 vs SD at $160.42.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $438.54 | $103.1K | 235 | 9 |
| HI | $380.49 | $95.1K | 250 | 7 |
| CA | $362.29 | $3.1M | 8.5K | 223 |
| UT | $347.47 | $370.1K | 1.1K | 31 |
| CT | $340.09 | $491.4K | 1.4K | 46 |
| RI | $340.01 | $145.9K | 429 | 13 |
| MD | $337.74 | $1.1M | 3.3K | 71 |
| NJ | $330.87 | $1.1M | 3.3K | 85 |
| OR | $327.15 | $408.9K | 1.3K | 38 |
| MN | $324.69 | $430.9K | 1.3K | 43 |
| NY | $323.01 | $1.6M | 5.0K | 130 |
| CO | $322.88 | $995.4K | 3.1K | 72 |
| IL | $320.54 | $1.6M | 4.9K | 122 |
| DE | $311.48 | $407.1K | 1.3K | 17 |
| IA | $310.72 | $464.8K | 1.5K | 40 |
| WA | $309.62 | $1.1M | 3.5K | 89 |
| MI | $309.41 | $740.4K | 2.4K | 79 |
| FL | $305.44 | $3.2M | 10.3K | 211 |
| WY | $304.76 | $122.8K | 403 | 15 |
| ME | $303.49 | $90.1K | 297 | 11 |
| NH | $303.40 | $345.6K | 1.1K | 28 |
| NC | $299.86 | $1.1M | 3.8K | 100 |
| GA | $295.78 | $1.0M | 3.4K | 89 |
| AZ | $293.90 | $1.3M | 4.5K | 77 |
| VA | $292.51 | $1.2M | 4.0K | 87 |
| MA | $286.97 | $741.0K | 2.6K | 73 |
| IN | $286.18 | $899.5K | 3.1K | 86 |
| NE | $281.09 | $310.3K | 1.1K | 28 |
| MS | $280.52 | $419.1K | 1.5K | 27 |
| MT | $280.29 | $229.6K | 819 | 21 |
| AL | $280.27 | $531.1K | 1.9K | 48 |
| NV | $279.89 | $284.1K | 1.0K | 22 |
| WI | $279.58 | $513.3K | 1.8K | 58 |
| TN | $277.05 | $915.6K | 3.3K | 71 |
| PA | $273.10 | $1.5M | 5.6K | 143 |
| OH | $271.91 | $1.1M | 4.1K | 118 |
| MO | $270.14 | $499.8K | 1.9K | 51 |
| KS | $269.53 | $414.5K | 1.5K | 41 |
| DC | $264.71 | $51.1K | 193 | 6 |
| SC | $264.51 | $832.7K | 3.1K | 67 |
| TX | $261.87 | $1.6M | 6.1K | 156 |
| LA | $261.32 | $302.9K | 1.2K | 31 |
| AR | $254.80 | $269.3K | 1.1K | 31 |
| ID | $252.64 | $230.9K | 914 | 19 |
| NM | $252.23 | $120.1K | 476 | 14 |
| VT | $252.10 | $58.2K | 231 | 6 |
| KY | $246.95 | $227.4K | 921 | 28 |
| WV | $234.20 | $35.4K | 151 | 6 |
| ND | $225.27 | $105.7K | 469 | 12 |
| OK | $218.28 | $240.1K | 1.1K | 33 |
| SD | $160.42 | $82.3K | 513 | 14 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| David Chan | Hand Surgery | FL | $150.5K | 334 | $450.65 |
| Lutherville Surgicenter, Llc | Ambulatory Surgical Center | MD | $142.2K | 311 | $457.20 |
| Surgery Center Of Allentown Llc | Ambulatory Surgical Center | PA | $133.5K | 299 | $446.39 |
| Stephen Helgemo | Hand Surgery | FL | $130.8K | 319 | $409.90 |
| Sf Nassau Asc Llc | Ambulatory Surgical Center | NY | $112.0K | 203 | $551.66 |
| Santa Rosa Surgery Center L P | Ambulatory Surgical Center | CA | $111.0K | 180 | $616.58 |
| Physicians Surgicenter Llc | Ambulatory Surgical Center | NJ | $107.0K | 229 | $467.31 |
| Orthopaedic Surgery Center Of San Antonio Lp | Ambulatory Surgical Center | TX | $105.5K | 284 | $371.59 |
| Orthopaedic Surgery Center Of Asheville, Lp | Ambulatory Surgical Center | NC | $104.7K | 248 | $421.98 |
| Orthopedic Surgery Center Of Oc Llc | Ambulatory Surgical Center | CA | $103.9K | 189 | $549.88 |
| Chippenham Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | VA | $103.6K | 225 | $460.48 |
| Ravine Way Surgery Center, Llc | Ambulatory Surgical Center | IL | $101.1K | 220 | $459.61 |
| Madison Physician Surgery Center, Llc | Ambulatory Surgical Center | MS | $97.9K | 236 | $414.68 |
| Beltway Surgery Centers Llc | Ambulatory Surgical Center | IN | $97.3K | 212 | $458.98 |
| Focus Hand Surgicenter Llc | Ambulatory Surgical Center | CO | $95.8K | 193 | $496.52 |
| E-Asc Llc | Ambulatory Surgical Center | OH | $93.7K | 208 | $450.42 |
| Banner Union Hills Surgery Center Llc | Ambulatory Surgical Center | AZ | $88.0K | 200 | $439.90 |
| First State Surgery Center, Llc | Ambulatory Surgical Center | DE | $87.7K | 194 | $451.81 |
| Orthoarizona Scottsdale Asc, Llc | Ambulatory Surgical Center | AZ | $85.2K | 177 | $481.34 |
| Bellaire Outpatient Surgery Center, Llp | Ambulatory Surgical Center | TX | $85.1K | 216 | $394.06 |
The data suggests significant pricing inconsistencies for CPT 26055. With a 2.7x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.