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See a sample rate comparisonCPT 21725 Fee Schedule
Last Verified: October 2026
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.
Divisi Of Sternocleidomasto For Torticollis Open Opera; W/, Division Of Sternocleidomastoid For Torticollis Open Operation; With
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21725 |
| Medicaid Fee Schedule | View Medicaid rates for 21725 |
National average reimbursement for CPT 21725 by major payers:
$728.96
$718.06
$740.30
$883.05
Compare published rates across providers.
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CPT 21725
5 of 25 sample ratesHigher to lower in this preview
Performance Health Surgicenter, LLC
Performance Health Surgicenter LLC
$4,215.00Published rateMaple Grove Center For Restorative Surgery
Center For Restorative Surgery At Maple Grove LLC
$722.00Published rateArizona Advanced Surgery Center, LLC
Arizona Advanced Surgery Center LLC
$425.00Published rateSurgery Center Of Bji, LLC
Surgery Center Of Bji LLC
$351.00Published rateHazleton Endoscopy Center, Inc.
Hazleton Endoscopy Center Inc
$200.00Published rate
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See a sample payer proposalCPT 21725 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21725 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal 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 21725 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 |
|---|---|---|
| 21720-CPT | Moderate | Divisi Of Sternocleidomasto For Torticollis Open Opera; W/O, Division Of Sternocleidomastoid For Torticollis Open Operation; Witho |
| 21725-CPT | Moderate | Divisi Of Sternocleidomasto For Torticollis Open Opera; W/, Division Of Sternocleidomastoid For Torticollis Open Operation; With |
| 21740-CPT | High | Chest Reconstructive Surgery, Surgery To Correct Bone Growth That Has Resulted In The Breastbone Caving Inward Or Pushing Outward. |
| 21742-CPT | High | Repair Stern Nuss W O Scope, Reconstructive Repair Of Pectus Excavatum Or Carinatum Minimally Invasive Approach Nuss Procedure Without Thoracoscopy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21725. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21725 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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