CPT 25120 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 25120 by major payers:
$683.53
$718.54
$724.81
$883.29
| 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 25120 | ||||||
United | 25120 | $1496.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1500.00 | 1407016561 - THOMASVILLE SURGERY CENTER, INC. | 582233903 - (GA) THOMASVILLE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $900.00 | 1891701611 - ESSEX ENDOSCOPY CENTER LLC | 223777761 - (NJ) ESSEX ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $3985.00 | 1922234855 - EYE SURGERY CENTER OF GEORGIA, LLC | 262852432 - (GA) EYE SURGERY CENTER OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1300.00 | 1497029466 - MOUNTAIN HOME SURGERY CENTER, INC. | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1850.00 | 1073987053 - SERENITY SURGICAL, LLC | 471546645 - (IN) SERENITY SURGICAL, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $2931.00 | 1184664609 - ENDOSCOPY CENTER AT ROBINWOOD, LLC | 20615867 - (MD) ENDOSCOPY CENTER AT ROBINWOOD LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $2835.00 | 1073149365 - MEDFORD SURGERY CENTER LLC | 384079196 - (MA) MEDFORD SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $4140.00 | 1649793613 - BAYLOR SURGICARE AT BLUE STAR, LLC | 812931756 - (TX) BAYLOR SURGICARE AT BLUE STAR LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1649.00 | 1710081443 - VENTURA ENDOSCOPY CENTER LLC | 680543503 - (CA) VENTURA ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $4339.00 | 1366416125 - TEXAS ORTHOPEDICS SURGERY CENTER, LLC, TEXAS ORTHOPEDICS SURGERY CENTER LIMITED PARTNERSHIP, LL | 743013713 - (TX) TEXAS ORTHOPEDICS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $2404.00 | 1023001377 - SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC | 371377370 - (IL) SOUTHERN ILLINOIS ORTHOPEDIC CENTERLLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1927.00 | 1437801388 - FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | 863588248 - (WI) FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $3502.00 | 1790130672 - PROSPECT DCMH, LLC, SHORT PROCEDURE UNIT | 811520273 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25120 | $1804.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | 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 25120 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25120 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 25120 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 |
|---|---|---|
| 25120-CPT | Moderate | Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Radius Or Ulna (Excluding Head Or Neck Of Radius And Olecranon Process); |
| 25125-CPT | Moderate | Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Radius Or Ulna (Excluding Head Or Neck Of Radius And Olecranon Process); With Autograft (Includes Obtaining Graft) |
| 25126-CPT | Moderate | Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Radius Or Ulna (Excluding Head Or Neck Of Radius And Olecranon Process); With Allograft |
| 25170-CPT | High | Extensive Removal Of Growth Of Forearm Bone (Radius Or Ulna) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25120 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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