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See a sample rate comparisonCPT 20525 Fee Schedule
Medicare rates as of October 2026
CPT 20525 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Removal Of Foreign Body In Mus, Removal Of Foreign Body In Muscle Or Tendon Sheath Deep Or Complicated Removal Of Foreign Body In Muscle Or Tendon Sheath Deep Or
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5073 - Level 3 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 77002 |
| Common Revenue Codes | 04500360Sign up to view all 12 |
| Medicare Fee Schedule | $497.01 national non-facility rate (2026)View Medicare rates for 20525 |
| Medicaid Fee Schedule | $397.01 median of the 8 states in the free previewView Medicaid rates for 20525 |
National average reimbursement for CPT 20525 by major payers:
$572.72
BCBS / Anthem
$626.36
UnitedHealthcare
$653.98
Aetna
$424.22
Cigna
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CPT 20525
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Sugar Land LLP
$5,729.00Published rateSurgical Elite Of Avondale, LLC
Surgical Elite Of Avondale LLC
$2,206.00Published rateCoronado Surgery Center, LLC
$1,282.00Published rateKumar Surgical Center LLC
$638.00Published rateParkhill Surgery Center Plano, LLC
$588.00Published rate
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See a sample payer proposalCPT 20525 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20525. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20520-CPT | Removal Of Foreign Body In Mu, Removal Of Foreign Body In Muscle Or Tendon Sheath Simple Removal Of Foreign Body In Muscle Or Tendon Sheath Simple |
| 20525-CPT | Removal Of Foreign Body In Mus, Removal Of Foreign Body In Muscle Or Tendon Sheath Deep Or Complicated Removal Of Foreign Body In Muscle Or Tendon Sheath Deep Or |
| 20550-CPT | Inject(S); Sngle Tndon Sheath Or Ligamnt Aponeurosis, Injection(S); Single Tendon Sheath Or Ligament Aponeurosis (Eg Plan |
| 20600-CPT | Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Small Jointbursa Or Ganglion Cyst (Eg Fingers Toes)Arthrocentesis Aspiration Andor Injection Sm All Joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20525 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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Frequently Asked Questions
What APC is CPT 20525 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20525 to APC 5073 (Level 3 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20525 in an ambulatory surgery center?
CMS lists CPT 20525 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 20525?
CMS add-on code edits list CPT 20525 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20525?
Hospital price transparency files list CPT 20525 under these revenue codes: including 0450, 0360, 0361, 0981 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.