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See a sample rate comparisonCPT 25031 Fee Schedule
Last Verified: September 2026
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.
Drain Arm Or Wrist Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Lower Arm Or Wrist.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 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 25031 |
| Medicaid Fee Schedule | View Medicaid rates for 25031 |
National average reimbursement for CPT 25031 by major payers:
$509.16
$498.94
$501.36
$617.49
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CPT 25031
5 of 25 sample ratesHigher to lower in this preview
Grapevine Surgicare Partners Ltd, Baylor Scott & White Surgicare - Southlake
Grapevine Surgicare Partners Ltd
$3,500.00Published ratePinnacle Surgery Center Of Austin
Pinnacle Surgery Center Of Austin LLC
$2,000.00Published rateEl Dorado Surgery Center Lp, Tucson Surgery Center
$1,477.00Published ratePhysicians Eye Surgery Center, Inc
Physicians Eye Surgery Center Inc
$1,078.00Published rateEndoscopy Center Of Topeka Lp, The Endoscopy And Surgery Center Of Topeka
The Endoscopy Center Of Topeka L
$577.00Published rate
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See a sample payer proposalCPT 25031 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25031 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 25031 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 |
|---|---|---|
| 25028-CPT | Moderate | Drain Arm Or Wrist Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Lower Arm Or Wrist. |
| 25031-CPT | Moderate | Drain Arm Or Wrist Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Lower Arm Or Wrist. |
| 25035-CPT | Moderate | Ncision Deep Bone Cortex Forearm Wrist (Eg Osteomyeli, Incision Deep Bone Cortex Forearm And/Or Wrist (Eg Osteomyelitis O |
| 25066-CPT | Moderate | Biops Sft Tissue Of Forearm Wrist; Deep (Subfasci Or Intra, Biopsy Soft Tissue Of Forearm And/Or Wrist; Deep (Subfascial Or Intra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25031. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25031 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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