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See a sample rate comparisonHealthcare 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 |
| Medicare Fee Schedule | View Medicare rates for 25001 |
| Medicaid Fee Schedule | View Medicaid rates for 25001 |
National average reimbursement for CPT 25001 by major payers:

$475.02

$454.50

$475.96

$570.33
Choose a payer to see a sample of rates for CPT 25001.
Aurora Surgery Centers LLC
Bucks County Surgical Suites
Surgcenter Of Palm Beach Gardens, LLC
Surgery Center Of Southern Oregon, L.L.C.
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 | Wrist Tendon Surgery, Surgery To Cut The Tendon Sheath (Covers The Tendon) Of Either The Flexor Or Extensor Tendon In The Wrist. |
| 25001-CPT | Moderate | Wrist Tendon Surgery, Surgery To Cut The Tendon Sheath (Covers The Tendon) Of Either The Flexor Or Extensor Tendon In The Wrist. |
| 25020-CPT | Moderate | Surgery On Lower Arm, Surgery To Cut The Connective Tissue In The Lower Arm Or Wrist. The Procedure May Involve Removal Of Tissue Damaged By Buildup Of Pressure From Swelling (Compartment Syndrome). |
| 25023-CPT | High | Surgery On Lower Arm, Surgery To Cut The Connective Tissue In The Lower Arm Or Wrist. The Procedure May Involve Removal Of Tissue Damaged By Buildup Of Pressure From Swelling (Compartment Syndrome). |
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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