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Every billing code / CPT 26725 / Summit Pacific Medical Center

CPT 26725 at Summit Pacific Medical Center

Musculoskeletal

Summit Pacific Medical Center, Elma

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 Summit Pacific Medical Center publishes for this code: as an outpatient

Who paysHospital’s fee (lowest – highest)Doctor’s fee the hospital lists
Commercial insuranceInsurer rates$3,999 – $5,1423 plans$382
Medicare AdvantageInsurer rates$1,428 – $1,5143 plans$328 – $347
Medicaid managed careInsurer rates$1,320 – $1,4523 plans$212 – $233
Other government programInsurer rates$1,4281 plan$328
UnknownInsurer rates$1,320 – $4,8563 plans$212 – $454
Cash pricePaying yourself, without insurance$3,085$1,177
List priceBefore any discount; few people pay it$5,713$2,179

Lowest and highest amounts Summit Pacific Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-31. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

BillWhat it’s forOriginal Medicare allowsPrivate plan estimate
Hospital's feeThe hospitalThe operating or procedure room, nursing, supplies and recovery—The price above
Surgeon or doctor doing itThe doctor's practiceThe procedure, and routine follow-up visits for 90 days$328$386 – $586
AnesthesiaAn anesthesia group (only sometimes)Anesthesia or deep sedation, if you need itOnly if an anesthesia team is part of your care. Its amount depends on how long it takes.——

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare CPT 26725 at every Washington hospital, with Medicare’s reference amounts.