CPT 25075 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 11 - Office • 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 25075 |
National average reimbursement for CPT 25075 by major payers:
$572.84
$622.49
$697.08
$827.44
| 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 25075 | ||||||
United | 25075 | $1024.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $523.00 | 1992192488 - WEST PACES SURGERY CENTER LLC | 473360333 - (GA) WEST PACES SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $815.00 | 1932145109 - VALLEY DIGESTIVE CENTER INC, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $855.90 | 1205182854 - AMAL PAUL | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 25075 | $1179.00 | 1912933680 - SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC | 562422009 - (PA) SOUTHWESTERN AMBULATORY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $809.00 | 1780959007 - COLUMBIA RIVER SURGERY CENTER LLC | 452481484 - (OR) COLUMBIA RIVER SURGERY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $1233.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $839.00 | 1396823381 - HEAD AND NECK SURGERY ASSOCIATES, PSC, CENTER FOR SURGICAL CARE | 610938951 - HEAD & NECK SURGERY ASSOC., PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $645.00 | 1245266790 - ABILENE SPINE & JOINT SURGERY CENTER PA | 752845382 - (TX) ABILENE SPINE JOINT SURGERY CENTER PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $855.90 | 1811092307 - GINA HUHNKE | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 25075 | $393.25 | 1306395439 - VIRGINIA LATOUCHE | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 25075 | $1103.00 | 1386999662 - PALOS HILLS SURGERY CENTER, LLC | 451617538 - (IL) PALOS HILLS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $423.00 | 1831167329 - THIBODAUX ENDOSCOPY LLC | 810548522 - (LA) THIBODAUX ENDOSCOPY, L.L.C. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $565.00 | 1770004772 - NORTHWEST ATLANTA VASCULAR CARE LLC | 453857694 - (GA) NORTHWEST ATLANTA VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25075 | $1147.00 | 1851356786 - WAUSAU SURGERY CENTER LLC | 621525773 - (WI) WAUSAU SURGERY CENTER, L.P. | WI | 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 25075 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25075 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 25075 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 |
|---|---|---|
| 25071-CPT | Moderate | Exc Tumor Soft Tiss Forearm And Wrist Subq 3 Cm |
| 25073-CPT | Moderate | Exc Tumor Sft Tiss Forearm& Wrist Subfasc 3 Cm |
| 25075-CPT | Moderate | Removal (Less Than 3 Centimeters) Tissue Growth Beneath The Skin At Forearm And/Or Wrist |
| 25076-CPT | Moderate | Excision, Tumor, Soft Tissue Of Forearm And/Or Wrist Area, Subfascial (Eg, Intramuscular); Less Than 3 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25075. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25075 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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