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Every billing code / CPT 26742 / Three Rivers Hospital

CPT 26742 at Three Rivers Hospital

Musculoskeletal

Three Rivers Hospital, Brewster

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 Three Rivers Hospital publishes for this code: as an outpatient

Who paysHospital’s fee (lowest – highest)Doctor’s fee the hospital lists
Medicaid managed careInsurer rates—$540
Medicaid (state program)Insurer rates—$540
Medicare (traditional)Insurer rates—$385 – $395
UnknownInsurer rates—$395 – $633
Cash pricePaying yourself, without insurance—$772
List priceBefore any discount; few people pay it—$772

Lowest and highest amounts Three Rivers Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. 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$346$408 – $619
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 26742 at every Washington hospital, with Medicare’s reference amounts.