CPT 23525 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 Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23525 |
National average reimbursement for CPT 23525 by major payers:
$528.73
$501.23
$529.84
$653.06
| 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 23525 | ||||||
United | 23525 | $318.00 | 1487604500 - CYPRESSWOOD SURGERY CENTER LLC, LEGENT SURGERY CENTER CYPRESSWOOD | 680600120 - (TX) CYPRESSWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $1446.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $522.00 | 1144283292 - LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | 943419282 - (LA) LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $170.00 | 1962467951 - GADSDEN SURGERY CENTER LP | 621488653 - (AL) GADSDEN SURGERY CENTER LP | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $500.00 | 1508934373 - CENTERS FOR PAIN SOLUTIONS,LLC | 20522938 - (NH) CENTERS FOR PAIN SOLUTIONSLLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $69.00 | 1689735250 - VISION CORRECTION CENTER, LLC | 820544613 - (AL) VISION CORRECTION CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $108.00 | 1972675668 - TEXAS REGIONAL EYE CENTER ASC LLC, TEXAS REGIONAL EYE CENTER ASC LLC | 710967940 - (TX) TEXAS REGIONAL EYE CENTER ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $1029.00 | 1023341740 - OPHTHALMOLOGY SURGERY CENTER OF DALLAS, LLC | 261914835 - (TX) OPHTHALMOLOGY SURGERY CENTER OF DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $344.00 | 1225075435 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE SURGICENTER-COTTONWOOD | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $748.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $300.00 | 1467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER | 204413058 - (WA) SOUTH SOUND SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $142.00 | 1306093604 - BOX CANYON SURGERY CENTER LLC | 263086826 - (NV) BOX CANYON SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $758.00 | 1770566192 - SUMMERLIN BEND SURGERY CENTER LLP, ADULT & CHILDRENS SURGERY CENTER OF SOUTHWEST FLORIDA | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $477.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23525 | $1029.00 | 1407592769 - TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC, TEXAS HEALTH ORTHOPEDIC AND SPINE SURGERY CENTER | 841953918 - (TX) TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC | TX | 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 23525 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23525 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 23525 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 |
|---|---|---|
| 23485-CPT | High | Osteotomy, Clavicle, With Or Without Internal Fixation; With Bone Graft For Nonunion Or Malunion (Includes Obtaining Graft And/Or Necessary Fixation) |
| 23505-CPT | Moderate | Red Fx-Clavicle |
| 23515-CPT | Moderate | Red Fx Open-Clavicle |
| 23525-CPT | Moderate | Red Disloc-Sternoclavicular |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23525 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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