CPT 25136 Fee Schedule

CPT 25136 vs. Other Surgical Procedures on the Forearm and Wrist Codes

The CPT 25136 code is part of the Excision Procedures on the Forearm and Wrist services used for Surgical Procedures on the Forearm and Wrist. 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 25136 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.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25136. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 25136 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.