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See a sample rate comparisonCPT 25265 Fee Schedule
Medicare rates as of October 2026
CPT 25265 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $688.06 national non-facility rate (2026) · View Medicare rates for 25265 |
| Medicaid Fee Schedule | $551.575 median of the 8 states in the free preview · View Medicaid rates for 25265 |
National average reimbursement for CPT 25265 by major payers:
$1,035.39
BCBS / Anthem
$1,052.99
UnitedHealthcare
$1,037.10
Aetna
$1,266.37
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 25265.
CPT 25265
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Azle
$11,871.00Published rateAdvanced Surgical Care Of Clearwater LLC
$3,623.00Published rateSunset Surgical Centre LLC
$2,240.00Published rateCardiovascular Surgical Suites LLC
Cardiovascular Surgical Suites L
$1,437.00Published rateVision Surgical Center At Springhill Psc
$643.00Published rate
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See a sample payer proposalCPT 25265 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25265. 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. |
| 25312-CPT | Moderate | Transplant Forearm Tendon, Tendon Transplantation Or Transfer Flexor Or Extensor Forearm And Or Wrist Single With Tendon Graft S Includes Obtaining Graft Each Tendon |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25265 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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