CPT 25170 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Excision Procedures on the Forearm and Wrist Surgical Procedures on the Forearm and Wrist |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25170 |
National average reimbursement for CPT 25170 by major payers:
$1,846.95
$1,848.01
$1,937.31
$2,294.30
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 25170 | $1893.00 | 1528021573 - SUMMIT SURGERY CENTER LP | 621777535 - (TN) SUMMIT SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1800.00 | 1578147484 - EPIC SURGERY CENTER LLC | 844244016 - (AZ) EPIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1300.00 | 1558328518 - BUTLER AMBULATORY SURGERY CENTER L L C | 61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $3500.00 | 1083938765 - MEDICAL PARK TOWER SURGERY CENTER, LLC, MEDICAL PARK TOWER SURGERY CENTER | 270543475 - (TX) MEDICAL PARK TOWER SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $4696.00 | 1669895512 - AMBULATORY SURGICAL CENTER OF SOMERVILLE LLC, SOMERSET AMBULATORY SURGICAL CENTER | 371743209 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $2200.00 | 1528219474 - CLARKSTON ASC PARTNERS LLC, CLARKSTON SURGERY CENTER | 203360827 - (MI) CLARKSTON ASC PARTNERS, LLC DBA CLARKSTON SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1352.00 | 1396733945 - EYE LASER & SURGERY CENTER OF COLUMBUS, LLC | 640942234 - (MS) EYE LASER SURGERY CENTER OF COLUMBUS LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $3570.00 | 1366416125 - TEXAS ORTHOPEDICS SURGERY CENTER, LLC, TEXAS ORTHOPEDICS SURGERY CENTER LIMITED PARTNERSHIP, LL | 743013713 - (TX) TEXAS ORTHOPEDICS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $2855.00 | 1154911592 - BCC WEST VALLEY LLC | 854264663 - (AZ) BCC WEST VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $756.00 | 1235394529 - ACCOMODATIVE SURGERY CENTER, L.L.C., BRECKSVILLE SURGERY CENTER | 203292823 - (OH) ACCOMODATIVE SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $2808.00 | 1457087926 - SPOKANE UROLOGY, PLLC, UROLOGY SURGERY CENTER NORTHWEST | 911043589 - (WA) SPOKANE UROLOGY, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1100.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1053.00 | 1811933179 - KALAMAZOO ENDO CENTER LLC | 201582174 - (MI) KALAMAZOO ENDO CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $6310.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25170 | $1707.00 | 1477178879 - SURGCENTER OF FAYETTEVILLE, LLC | 844038708 - (AR) SURGCENTER OF FAYETTEVILLE LLC | AR | 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 25170 vs. Other Surgical Procedures on the Forearm and Wrist Codes
The CPT 25170 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 25170 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 |
|---|---|---|
| 25119-CPT | Moderate | Remove Wrist Tendon Covering, Surgery To Remove Sheath (Covering) Of Tendon Located Over Wrist Joint. Procedure Is Done To Relieve Pain And Increase Joint Mobility. |
| 25120-CPT | Moderate | Excision Or Curettage Of Bone, Excision Or Curettage Of Bone Cyst Or Benign Tumorof Radiusor Ulna (Excluding Head Or Neck Of Radiu S And Olecranon Process) |
| 25170-CPT | High | Surgery For Tumor In Arm Bone, Surgery To Remove A Section Of Bone With An Abnormal Growth (Tumor) From The Arm Elbow Or Wrist. The Bone May Be Reconstructed With A Graft Or Prosthesis. |
| 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 25170. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25170 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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