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See a sample rate comparisonCPT 25115 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
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
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 25115 |
| Medicaid Fee Schedule | View Medicaid rates for 25115 |
National average reimbursement for CPT 25115 by major payers:
$1,065.58
$1,054.78
$1,070.63
$1,271.67
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CPT 25115
5 of 25 sample ratesHigher to lower in this preview
Baycare Aurora Kaukauna Surgery Center LLC, Kaukauna Surgery Center
Baycare Aurora Kaukauna Surgery Center LLC
$7,810.00Published rateNorthern Plains Surgery Center LLC
Northern Plains Surgery Center, LLC
$1,800.00Published rateDoctors Outpatient Surgery Center LLC, Surgery Center
Doctors Outpatient Surgery Center LLC
$1,232.00Published rateOutpatient Surgical Care Ltd
$872.00Published rateFront Range Endoscopy Centers, LLC
Front Range Endoscopy Centers LLC
$650.00Published rate
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See a sample payer proposalCPT 25115 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25115 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 25115 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 |
| 25116-CPT | Moderate | Remove Wrist Forearm Lesion, Radical Excision Of Bursa Synovia Of Wrist Or Forearm Tendon Sheaths Eg Tenosynovitis Fungus Tbc Or Other Granulomas Rheumatoid Arthritis Extensors With Or Without Transposition Of Dorsal Retinaculum |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25115. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25115 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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