Rate Benchmarking
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See a sample rate comparisonCPT 25135 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
| 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 | LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $541.10 national non-facility rate (2026) · View Medicare rates for 25135 |
| Medicaid Fee Schedule | $432.965 median of the 8 states in the free preview · View Medicaid rates for 25135 |
National average reimbursement for CPT 25135 by major payers:

$776.12
BCBS / Anthem

$758.04
UnitedHealthcare

$766.86
Aetna

$927.77
Cigna
Choose a payer to see a sample of rates for CPT 25135.
Texas Health Harris Methodist Hospital Hurst-Euless-Bedford
Red Cedar Surgery Center, LLC, Red Cedar Surgery Center, PLLC
Red Cedar Surgery Center, PLLC
High Desert Surgery Center, L.L.C.
High Desert Surgery Center LLC
Digestive Diseases Diagnostic & Treatment Center LLC
Digestive Diseases Diagnostic Treatment Center LLC
Minimally Invasive Surgery Center, P.A.
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 table lists codes related to 25135. Select one to see its fee schedule.
| 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.
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