We’re increasing our physician fee schedule for CPT codes 26055 and 64721 when performed in an office-based setting beginning Oct. 1, 2019

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 increase the fee schedule for CPT codes 26055 and 64721 when performed in an office-based setting, effective with dates of service on or after Oct. 1, 2019.

CPT Description
26055 Tendon sheath incision (e.g., for trigger finger) 
64721 Neuroplasty and/or transposition; median nerve at carpal tunnel 

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. 

To view the new changes for CPT codes 26055 and 64721 view your fee schedule