Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHealthcare 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25135 |
| Medicaid Fee Schedule | View Medicaid rates for 25135 |
National average reimbursement for CPT 25135 by major payers:

$776.12

$758.04

$766.86

$927.77
Choose a payer to see a sample of rates for CPT 25135.
Red Cedar Surgery Center, PLLC
High Desert Surgery Center LLC
Digestive Diseases Diagnostic Treatment Center LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 25135 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25135 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 25135 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 |
|---|---|---|
| 25130-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones In The Hand. |
| 25135-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25136-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25210-CPT | Moderate | Carpectomy Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25135. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25135 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.
Bring your top codes (like CPT 25135) and we'll show you how you compare in 15 minutes or less.