CPT 16025 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 20 - Urgent Care Facility |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 16025 by major payers:
$180.34
$192.37
$195.72
$254.66
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 16025 | ||||||
United | 16025 | $318.00 | 1700546629 - STONE OAK SURGICENTER, LLC | 873925488 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $250.00 | 1194341768 - WELLINGTON SPECIALTY SURGERY CENTER, LLC | 844962361 - (OH) WELLINGTON SPECIALTY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $65.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $252.00 | 1114584786 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $156.00 | 1104868561 - REGIONAL SURGERY CENTER, P.C. | 431527254 - (MO) REGIONAL SURGERY CENTER PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $84.00 | 1922180439 - DL-JT MANAGEMENT SERVICES, LLC, CENTENNIAL SURGERY CENTER, LLC | 880499721 - CENTENNIAL SPINE & PAIN CENTER | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $156.00 | 1104868561 - REGIONAL SURGERY CENTER, P.C. | 431527254 - (MO) REGIONAL SURGERY CENTER PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $163.00 | 1841952397 - SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES, LLC | 853643949 - (OK) SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $150.00 | 1407202484 - SPORTSORTHO SURGERY CENTER LLC | 811465819 - (TX) SPORTSORTHO SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $318.00 | 1316936016 - WESTLAKE SPINE & OUTPATIENT SURGERY CENTER | 204997865 - (CA) JOURNEY LITE OF THE CENTRAL COAST LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $380.00 | 1710979109 - SHEEPSHEAD BAY SURGERY CENTER, INC., SHEEPSHEAD BAY SURGERY CENTER | 61530394 - (NY) SHEEPSHEAD BAY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $656.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $220.00 | 1770114290 - NORTH SUBURBAN PAIN AND SPINE CENTER LLC | 824454412 - (IL) NORTH SUBURBAN PAIN & SPINE CENT | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $200.00 | 1710203427 - HARLINGEN SURGICAL CENTER, LLC, VALLEY EYE SURGERY CENTER | 270561821 - (TX) HARLINGEN SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16025 | $833.00 | 1639452444 - CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC | 271462884 - (NJ) CHILDRENS AMBULATORY SURGERY CENTER OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 16025 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 16025 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 16025 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 16000-CPT | Low | Init Treat 1st Degree Burn Local |
| 16020-CPT | Low | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Small (Less Than 5% Total Body Surface Area) |
| 16025-CPT | Low | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Medium (Eg, Whole Face Or Whole Extremity, Or 5% To 10% Total Body Surface Area) |
| 16030-CPT | Moderate | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Large (Eg, More Than 1 Extremity, Or Greater Than 10% Total Body Surface Area) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 16025. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 16025 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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