CPT 25001 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 25001 by major payers:
$475.02
$454.50
$475.96
$584.11
| 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 25001 | ||||||
United | 25001 | $1000.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $2775.00 | 1063040731 - POWDER RIVER SURGERY CENTER | 845166436 | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $2388.00 | 1841316841 - PACIFIC ENDOSCOPY CENTER, LLC | 203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLC | HI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $4141.00 | 1023316197 - NORTH DALLAS SURGICAL CENTER,LLC, TEXAS HEALTH SURGERY CENTER ADDISON | 272248103 - (TX) NORTH DALLAS SURGICAL CENTERLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $1380.00 | 1043690845 - UNION HILLS PAIN PARTNERS LLC, HONORHEALTH PAIN MANAGEMENT CENTER | 473325492 - (AZ) UNION HILLS PAIN PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $1778.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $2859.00 | 1184635955 - SAN RAMON ENDOSCOPY CENTER INC | 680466508 - (CA) SAN RAMON ENDOSCOPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $675.00 | 1588665665 - CERTIFIED AMBULATORY SURGERY CENTER, CASC | 522031681 - (MD) CERTIFIED AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $1264.00 | 1669540118 - STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC, VALLEY LASER SURGERY CENTER, INC. | 203111961 - (CA) STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $1550.00 | 1881184356 - BLACKBURN &WHITNEY MD PS, PLASTIC SURGERY BELLINGHAM | 912176854 - (WA) BLACKBURN & WHITNEY MD PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $757.00 | 1558327445 - MERCY AMBULATORY SURGERY CENTER LTD | 631178796 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $2025.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $730.00 | 1194790808 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $2311.00 | 1508851213 - FROEDTERT SURGERY CENTER, LLC | 201499345 - (WI) FROEDTERT SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25001 | $1700.00 | 1447232756 - APPLE VALLEY SURGERY CENTER | 273653631 - (CA) PERSEPOLIS GROUP LLC | CA | 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 25001 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25001 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 25001 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 25001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25001 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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