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See a sample rate comparisonCPT 25035 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.
Ncision Deep Bone Cortex Forearm Wrist (Eg Osteomyeli, Incision Deep Bone Cortex Forearm And/Or Wrist (Eg Osteomyelitis O
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25035 |
| Medicaid Fee Schedule | View Medicaid rates for 25035 |
National average reimbursement for CPT 25035 by major payers:
$850.05
$837.14
$833.89
$1,028.48
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CPT 25035
5 of 25 sample ratesHigher to lower in this preview
Hamilton Surgery Center LLC
$4,588.00Published rateWinter Haven Ambulatory Surgical Center LLC
Winter Haven Ambulatory Surgical Center, LLC
$2,388.00Published rateCenter For Pain Management Ambulatory Surgery, Ltd
Center For Pain Management Ambulatory Surgery Ltd
$1,530.00Published rateWheeling Hospital Ambulatory Surgery Center LLC
$1,131.00Published rateNorth Houston Endoscopy & Surgery
North Houston Endoscopy Surgery
$620.00Published rate
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See a sample payer proposalCPT 25035 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25035 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 25035 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 25035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25035 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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