CPT 25023 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25023 |
National average reimbursement for CPT 25023 by major payers:
$1,695.93
$1,562.22
$1,659.18
$2,068.54
| 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 25023 | ||||||
United | 25023 | $1484.00 | 1053391169 - ENDOSCOPY CENTER OF THE SOUTH BAY LP, ENDOSCOPY CENTER OF THE SOUTH BAY | 621555410 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $6175.00 | 1164486809 - SAINT LUKE'S SURGICENTER | 470853481 - (MO) SAINT LUKES SURGICENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $657.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $2224.00 | 1891395661 - SPINE SOLUTIONS OF SHEBOYGAN LLC | 853646323 - (WI) SPINE SOLUTIONS OF SHEBOYGAN LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $3570.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $1632.00 | 1114990231 - SURGERY CENTER OF MIDDLE TENNESSEE LLC, THE SURGERY CENTER OF MIDDLE TENNESSEE | 621839266 - (TN) SURGERY CENTER OF MIDDLE TENNESSEE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $10099.00 | 1497393516 - AURORA SURGERY CENTERS, LLC, AURORA PLEASANT PRAIRIE AMBULATORY SURGERY CENTER | 811401714 - (WI) AURORA SURGERY CENTERS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $940.00 | 1396069902 - SOUTHERN IDAHO SURGERY CENTER PLLC | 451149795 - (ID) SOUTHERN IDAHO SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $3623.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $1559.00 | 1548791593 - BRIDGEWATER AMBULATORY SURGERY CENTER, LLC | 820860675 - (NJ) BRIDGEWATER AMBULATORY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $2277.00 | 1497173801 - EHI SURGERY CENTER AUSTIN, LLC, LEGENT OUTPATIENT SURGERY - AUSTIN | 464266877 - (TX) EHI SURGERY CENTER AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $2010.00 | 1679804355 - LONESTAR AMBULATORY SURGICAL CENTER | 263806076 - (TX) LONESTAR AMBULATORY SURGICAL CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $1775.00 | 1104272780 - ENT OF SOUTH GEORGIA SURGERY CENTER LLC | 474050916 - (GA) ENT OF SOUTH GEORGIA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $1505.00 | 1740287168 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25023 | $1800.00 | 1861663098 - ASCENT SURGERY CENTER, LLC | 262011928 - (CO) ASCENT SURGERY CENTER LLC | CO | 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 25023 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25023 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 25023 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 |
|---|---|---|
| 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 |
| 25024-CPT | High | Incision Of Tissue Of Forearm And/Or Wrist Muscle Compartment On Both Sides Of The Forearm To Relieve Pressure, Without Removal Of Tissue |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25023. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25023 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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