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See a sample rate comparisonCPT 25109 Fee Schedule
Last Verified: September 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.
Excision Of Tendon Forearm And Or Wrist Flexor Or Extensor Each
| 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 25109 |
| Medicaid Fee Schedule | View Medicaid rates for 25109 |
National average reimbursement for CPT 25109 by major payers:
$747.68
$711.36
$736.18
$890.61
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CPT 25109
5 of 25 sample ratesHigher to lower in this preview
Southlake Ambulatory Surgery Center, Lllp, Spivey Station Surgery Center
Emory University
$4,263.00Published rateBraselton Endoscopy Center, LLC
Braselton Endoscopy Center LLC
$2,307.00Published rateJoon Y. Kim, Md, PC, Clayton Cataract & Laser Surgery Center
$1,350.00Published ratePremier Surgical Center, LLC
Premier Surgical Center LLC
$994.00Published rateKeystone Kidney Associates, PC
Keystone Kidney Associates PC
$600.00Published rate
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See a sample payer proposalCPT 25109 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25109 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 25109 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 |
|---|---|---|
| 25109-CPT | Moderate | Excision Of Tendon Forearm And Or Wrist Flexor Or Extensor Each |
| 25110-CPT | Moderate | Exc Lesion Tendon Sheath Forearm |
| 25115-CPT | High | Remove Wrist Forearm Lesion, Radical Excision Of Bursa Synovia Of Wrist Or Forearm Tendon Sheaths Eg Tenosynovitis Fungus Tbc Or Other Granulomas Rheumatoid Arthritis Flexors |
| 25260-CPT | Moderate | Repair Forearm Tendon Muscle, Repair Tendon Or Muscle Flexor Forearm And Or Wrist Primary Single Each Tendon Or Muscle |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25109. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25109 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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