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See a sample rate comparisonCPT 25126 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.
Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone Of The Lower Arm (Radius Or Ulna). The Procedure Uses A Bone Graft To Repair The Area.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 25126 |
| Medicaid Fee Schedule | View Medicaid rates for 25126 |
National average reimbursement for CPT 25126 by major payers:
$894.11
$850.42
$846.23
$1,020.35
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CPT 25126
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Bay Area Endoscopy Center, LLC, Bay Area Endoscopy
$7,838.00Published rateIowa City Ambulatory Surgical Center, LLC
Iowa City Ambulatory Surgical Center
$3,073.00Published rateMountain Empire Cataract & Eye Surgery Center
Mountain Empire Cataract Eye Surgery Center
$1,648.00Published rateThe Endoscopy Center At Bainbridge LLC
$1,130.00Published rateAdvanced Laser & Surgicenter Of Arizona, PC
$626.00Published rate
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See a sample payer proposalCPT 25126 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25126 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 25126 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 |
|---|---|---|
| 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 |
| 25125-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone Of The Lower Arm (Radius Or Ulna). The Procedure Uses A Bone Graft To Repair The Area. |
| 25126-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone Of The Lower Arm (Radius Or Ulna). The Procedure Uses A Bone Graft To Repair The Area. |
| 25350-CPT | Moderate | Surgery To Align Arm Bone, Surgery To Cut One Or More Bones In The Lower Arm (Radius Or Ulna). This Procedure Is Usually Done To Correct Positioning Of A Previously Broken Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25126. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25126 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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