CPT 25076 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 25076 by major payers:
$712.20
$697.53
$731.56
$875.19
| 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 25076 | ||||||
United | 25076 | $1955.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $415.23 | 1720156235 - STEVEN COOK | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 25076 | $614.00 | 1790167740 - TIDALHEALTH SURGERY CENTER, LLC | 474184623 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $1662.00 | 1548400229 - HARRIS COUNTY HOSPITAL DISTRICT, AMBULATORY SURGERY CENTER AT LBJ | 741536936 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $995.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $1276.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $942.00 | 1235240813 - NORTH MISSISSIPPI AMBULATORY SURGERY CENTER LLC | 200145190 - (MS) NORTH MISSISSIPPI AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $574.00 | 1548613755 - VERO BEACH FLORIDA ASC LLC, SEBASTIAN RIVER SURGERY CENTER | 300936810 - (FL) VERO BEACH FLORIDA ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $1233.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $902.00 | 1407869373 - VALENCIA ASC, LLC, VALENCIA SUGICAL CENTER | 954879092 - (CA) VALENCIA OUTPATIENT SURGICAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $903.72 | 1609154483 - TRESA NESBITT | 350593390 - DEACONESS HOSPITAL INC | GA | Hospitalist Physician (208M00000X) |
United | 25076 | $415.23 | 1023416252 - JODY SUTTON | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 25076 | $1181.00 | 1427282771 - UPSTATE ORTHOPEDICS AMBULATORY SURGERY CENTER LLC, UPSTATE ORTHOPEDICS ASC | 770711020 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $720.00 | 1457345530 - SYRINGA SURGICAL CENTER | 200968551 - (ID) SYRINGA SURGICAL CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25076 | $1666.00 | 1144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION | 223182653 | NJ | 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 25076 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25076 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 25076 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 25076. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25076 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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