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See a sample rate comparisonCPT 25100 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.
Exploratory Surgery Of Wrist, Surgery To Explore The Wrist Joint And Remove A Sample Of Tissue For Testing (Biopsy). The Procedure May Include Removing Bone Chips Or Loose Cartilage.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 25100 |
| Medicaid Fee Schedule | View Medicaid rates for 25100 |
National average reimbursement for CPT 25100 by major payers:
$503.85
$471.48
$484.33
$582.94
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CPT 25100
5 of 25 sample ratesHigher to lower in this preview
Saint Vincent Hlth Ctr Spu
Highmark Health
$8,082.25Published ratePoint Of Rocks Surgery Center, LLC
$2,307.00Published rateGolden Springs Surgical Center
$1,700.00Published rateJackson Heart And Vascular Center LLC
$1,077.00Published rateVision Surgery Center, LLC
Vision Surgery Center LLC
$663.00Published rate
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See a sample payer proposalCPT 25100 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25100 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 25100 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 | Xcision Tumor Sft Tissue Of Forearm Wrist Area Subcutan, Excision Tumor Soft Tissue Of Forearm And/Or Wrist Area Subcutaneou |
| 25075-CPT | Moderate | Xcision Tumor Sft Tissue Of Forearm Wrist Area Subcutan, Excision Tumor Soft Tissue Of Forearm And/Or Wrist Area Subcutaneou |
| 25076-CPT | Moderate | Exc Forearm Tum Deep 3 Cm, Excision Tumor Soft Tissue Of Forearm And Or Wrist Area Subfascial Eg Intramuscular Less Than 3 Cm |
| 25100-CPT | Moderate | Exploratory Surgery Of Wrist, Surgery To Explore The Wrist Joint And Remove A Sample Of Tissue For Testing (Biopsy). The Procedure May Include Removing Bone Chips Or Loose Cartilage. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25100 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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