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See a sample rate comparisonCPT 25260 Fee Schedule
Medicare rates as of October 2026
CPT 25260 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Repair Forearm Tendon Muscle, Repair Tendon Or Muscle Flexor Forearm And Or Wrist Primary Single Each Tendon Or Muscle
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $599.21 national non-facility rate (2026) · View Medicare rates for 25260 |
| Medicaid Fee Schedule | $480.76 median of the 8 states in the free preview · View Medicaid rates for 25260 |
National average reimbursement for CPT 25260 by major payers:
$896.45
BCBS / Anthem
$891.76
UnitedHealthcare
$915.99
Aetna
$1,104.65
Cigna
Compare published rates across providers.
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CPT 25260
5 of 25 sample ratesHigher to lower in this preview
Northshore Regional Medical Center Dba The Surgery Suite, The Surgery Suite
Ochsner Clinic Foundation
$16,288.00Published rateMorris Avenue Endoscopy LLC
Morris Avenue Endoscopy, LLC
$2,795.00Published rateDelmont Surgery Center, LLC
Delmont Surgery Center LLC
$1,582.00Published rateVision Care Center, A Medical Group Inc, Eye-Q Surgery Center
Vision Care Center, A Medical Group, Inc.
$1,072.50Published rateOrange County Digestive Center, Inc
Orange County Digestive Center, Inc.
$576.00Published rate
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See a sample payer proposalCPT 25260 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25260. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 25260-CPT | Moderate | Repair Forearm Tendon Muscle, Repair Tendon Or Muscle Flexor Forearm And Or Wrist Primary Single Each Tendon Or Muscle |
| 25263-CPT | Moderate | Repair Forearm Tendon Muscle, Repair Tendon Or Muscle Flexor Forearm And Or Wrist Secondary Single Each Tendon Or Muscle |
| 25265-CPT | High | Tendon Or Muscle Repair Of Arm, Surgery To Repair A Torn Tendon Or Muscle In The Lower Arm Or Wrist. When The Repair Is More Than 10 Days After An Injury (Or The First Procedure Failed To Restore Mobility) A Graft May Be Necessary To Bring The Ends Together. |
| 25310-CPT | Moderate | Move Tendon In Arm Or Wrist, Surgery To Remove Either The Flexor Or Extensor Tendon From Its Attachment And Transfer It Onto Another Tendon In The Lower Arm Or Wrist. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25260 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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