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See a sample rate comparisonCPT 25260 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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 | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25260 |
| Medicaid Fee Schedule | View Medicaid rates for 25260 |
National average reimbursement for CPT 25260 by major payers:
$896.45
$891.76
$915.99
$1,104.65
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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 CPT 25260 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 25260 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 |
|---|---|---|
| 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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