CPT 26113

Musculoskeletal

Current code40 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for CPT 26113 by hospital
Hospital	Medicare Advantage rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	$1,808 – $1,8445 plans	$3,935	$4,919
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$359 – $1,028Doctor’s fee: $668 – $1,028	$553 – $1,581Doctor’s fee: $1,028 – $1,581
Seattle Children's HospitalSeattle	—	$2,350	$2,350
Three Rivers HospitalBrewster	—	Doctor’s fee: $2,565	Doctor’s fee: $2,565
Virginia Mason Medical CenterSeattle	—	$3,049	$5,979

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $569 in a hospital or surgery center
Doctor's fee, rest of Washington: $517 in a hospital or surgery center
Hospital outpatient payment (national): $1,687 (APC 5072)
Surgery center payment (national): $742

How hospitals also write this code

Some price files write it differently. These are counted as CPT 26113:

26113P (with a letter after it, P; 2 price lines)
26113T (with a letter after it, T; 1 price line)