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See a sample rate comparisonCPT 25065 Fee Schedule
Last Verified: October 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.
Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office None |
| Common Modifiers | None 51 - Multiple procedures RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25065 |
| Medicaid Fee Schedule | View Medicaid rates for 25065 |
National average reimbursement for CPT 25065 by major payers:
$319.53
$330.27
$342.25
$406.61
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CPT 25065
5 of 25 sample ratesHigher to lower in this preview
Canonsburg General Hospital
Highmark Health
$4,278.10Published rateMemorial Surgery Center, LLC
Memorial Surgery Center LLC
$967.00Published rateIdox3 LLC, Tri-State Surgery Center
Idox3 LLC
$600.00Published rateMidwest Eye Center
$343.00Published rateAnna Boone
Deaconess Hospital Inc
$206.16Published rate
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See a sample payer proposalCPT 25065 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25065 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 25065 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 |
| 25065-CPT | Moderate | Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25065 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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