CPT 25125 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 25125 by major payers:
$850.26
$843.48
$828.05
$1,037.16
| 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 25125 | ||||||
United | 25125 | $1120.00 | 1710979109 - SHEEPSHEAD BAY SURGERY CENTER, INC., SHEEPSHEAD BAY SURGERY CENTER | 61530394 - (NY) SHEEPSHEAD BAY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $962.00 | 1780727636 - UNION SURGERY CENTER, INC, ADVANCED ENDOSCOPY CENTER | 205205858 - (CA) UNION SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1700.00 | 1801185665 - PERSEPOLIS GROUP LLC | 273653631 - (CA) PERSEPOLIS GROUP LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1244.00 | 1679791404 - SILVER SUMMIT MEDICAL CORPORATION, PREMIER SURGERY CENTER | 770284440 - (CA) SILVER SUMMIT MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $8000.00 | 1750071007 - DISC SURGERY CENTER AT MARINA DEL REY LLC | 880601479 - (CA) DISC SURGERY CENTER AT MARINA DEL REY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1053.00 | 1811378375 - ALEXANDRIA AMBULATORY SURGERY CENTER LP, ALEXANDRIA HEART & VASCULAR SURGERY CENTER | 471533012 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1600.00 | 1033363064 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM SURGERY CENTER | 300466706 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $6874.00 | 1437746674 - SUMMIT ORTHOPEDIC SURGERY CENTER, LLC, SOSC | 844141051 - (CO) SUMMIT ORTHOPEDIC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $896.00 | 1467458281 - EYE CARE AND SURGERY CENTER OF FT. LAUDERDALE, LLC, EYE CARE AND SURGERY CENTER OF FT. LAUDERDALE | 201344254 - (FL) EYE CARE AND SURGERY CENTER OF FT LAUDERDALE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1276.00 | 1922335900 - PALMETTO LAKES SURGICAL CENTER, LLC | 943459481 - (FL) PALMETTO LAKES SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1599.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1623.00 | 1629713730 - PG COUNTY ENDOSCOPY CENTER LLC | 881766792 - (MD) PG COUNTY ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $715.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1152.00 | 1134183056 - TOPEKA SURGERY CENTER | 364500418 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25125 | $1700.00 | 1568513950 - MASSACHUSETTS AVENUE SURGERY CENTER | 200815305 - (MD) MASSACHUSETTS AVENUE SURGERY CENTER, LLC | MD | 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 25125 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25125 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 25125 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 |
| 25350-CPT | Moderate | Osteotomy Radius Distal Third |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25125 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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