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See a sample rate comparisonCPT 25251 Fee Schedule
Last Verified: September 2026
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.
Removal Wrist Prosthesis;Complicated,Tot
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 25251 |
| Medicaid Fee Schedule | View Medicaid rates for 25251 |
National average reimbursement for CPT 25251 by major payers:
$1,001.27
$967.89
$976.07
$1,182.81
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CPT 25251
5 of 25 sample ratesHigher to lower in this preview
Canon City Co Multi Specialty Asc LLC, Arkansas Valley Surgery Center
Canon City Co Multi Specialty Asc LLC
$4,298.00Published rateAmbulatory Surgical Associates LLC, Tullahoma Surgery Center
Ambulatory Surgical Associates LLC
$3,347.00Published rateAmbulatory Surgery Center Of Burley, LLC
Ambulatory Surgery Center Of Burley LLC
$2,243.00Published rateSkin Surgery Center Ps, Skin Surgery Center
Skin Surgery Center P. S.
$1,403.00Published rateAdvanced Surgery Center Of Arizona, LLP, Advanced Surgery Center Of Arizona
$626.00Published rate
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See a sample payer proposalCPT 25251 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25251 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 25251 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 |
|---|---|---|
| 25250-CPT | Moderate | Remove Wrist Prosthesis |
| 25251-CPT | High | Removal Wrist Prosthesis;Complicated,Tot |
| 25259-CPT | Moderate | Physical Therapy Of Wrist, Manual Stretching And Rotation Of Wrist Under General Anesthesia To Regain Range Of Motion After Surgery. |
| 25332-CPT | High | Arthroplasty Wrist With Or W, Arthroplasty Wrist With Or Without Interposition With Or Without External Or Internal Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25251 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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