CPT 25000 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 25000 by major payers:
$515.63
$467.27
$493.67
$593.66
| 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 25000 | ||||||
United | 25000 | $850.00 | 1619049939 - ENDOSCOPY CENTER MONROE LLC, CAROLINA ENDOSCOPY CENTER MONROE | 260731594 - (NC) ENDOSCOPY CENTER MONROE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2388.00 | 1497165179 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF PHOENIX | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2010.00 | 1346918646 - TIMPVIEW ASC, LLC | 872314348 - (UT) TIMPVIEW ASC LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2281.00 | 1982641890 - SUMMIT MEDICAL GROUP PA, SUMMIT MEDICAL GROUP AMBULATORY SURGERY CENTER | 223487984 - SUMMIT MEDICAL GROUP, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2300.00 | 1114264488 - EXECUTIVE SURGERY CENTER, LLC | 300701899 - (TX) EXECUTIVE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2281.00 | 1093444010 - SUMMIT MEDICAL GROUP PA | 223487984 - SUMMIT MEDICAL GROUP, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1779.00 | 1346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | 270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1100.00 | 1417994831 - CATALINA SURGERY CENTER, LLC | 201680197 - (AZ) CATALINA SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1739.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1200.00 | 1093960395 - GRAYSTONE EYE SURGERY CENTER LLC | 205740206 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $2388.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364120432 - (IL) NORTH SHORE SAME DAY SURGERY LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1834.00 | 1861497380 - NORTHEAST NEBRASKA SURGERY CENTER LLC, FAITH REGIONAL SURGERY CENTER | 470819088 - (NE) NORTHEAST NEBRASKA SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $1530.00 | 1114057023 - CROSSROADS SURGERY CENTER INC | 205799348 - (MN) CROSSROADS SURGERY CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25000 | $270.95 | 1194989269 - GREGORY BURCHETT | 350593390 - DEACONESS HOSPITAL INC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 25000 | $2388.00 | 1952333882 - THE MARYLAND CENTER FOR DIGESTIVE HEALTH LLC | 470856276 | MD | 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 25000 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25000 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 25000 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 |
|---|---|---|
| 25000-CPT | Moderate | Inc Tendon Sheath At Radial Styloid |
| 25001-CPT | Moderate | Incision, Flexor Tendon Sheath, Wrist (Eg, Flexor Carpi Radialis) |
| 25020-CPT | Moderate | Incision Of Tissue Of Forearm And/Or Wrist Muscle Compartment On One Side Of The Forearm To Relieve Pressure, Without Removal Of Tissue |
| 25023-CPT | High | Decompression Fasciotomy, Forearm And/Or Wrist, Flexor Or Extensor Compartment; With Debridement Of Nonviable Muscle And/Or Nerve |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25000 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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