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See a sample rate comparisonCPT 25101 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 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25101 |
| Medicaid Fee Schedule | View Medicaid rates for 25101 |
National average reimbursement for CPT 25101 by major payers:
$564.77
$549.28
$578.47
$693.43
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CPT 25101
5 of 25 sample ratesHigher to lower in this preview
Gab Endoscopy Center LLC
$4,339.00Published rateBear Creek Surgery Center, LLC
$3,196.00Published rateTampa Bay Surgery Center Associates, Ltd.
Tampa Bay Surgery Center Assoc
$2,200.00Published ratePhysicians Eye Surgery Center LLC, Physicians' Eye Surgery Center
Physicians Eye Surgery Center
$1,414.00Published rateNorthern New Jersey Eye Institute PA
Northern New Jersey Eye Institute, P.A.
$796.00Published rate
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See a sample payer proposalCPT 25101 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25101 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 25101 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 |
| 25101-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 25101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25101 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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