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See a sample rate comparisonCPT 25275 Fee Schedule
Last Verified: October 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.
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 | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25275 |
| Medicaid Fee Schedule | View Medicaid rates for 25275 |
National average reimbursement for CPT 25275 by major payers:
$897.40
$902.86
$961.12
$1,105.35
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CPT 25275
5 of 25 sample ratesHigher to lower in this preview
New Gulf Coast Surgery Center, LLC
Gulfport Surgery Clinic, LLC
$9,239.00Published rateBaptist Health Surgery Center, LLC, Baptist Health Surgery Center At Plantation
Baptist Health Surgery Center LLC
$2,637.00Published rateCrossings Surgery Center, LLC
Crossings Surgery Center LLC
$2,050.00Published rateLagreca Eye Clinic, P.C., The Eye Clinic Surgicenter
Lagreca Eye Clinic, PC
$1,490.00Published rateThe Overland Park Ks Endoscopy Asc LLC, Endoscopic Imaging Center
The Overland Park Ks Endoscopy Asc LLC
$636.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 25275 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25275 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 25275 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 |
| 25274-CPT | Moderate | 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. |
| 25275-CPT | Moderate | 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. |
| 25316-CPT | High | Revise Palsy Hand Tendon S, Flexor Origin Slide Eg For Cerebral Palsy Volkmann Contracture Forearm And Or Wrist With Tendon S Transfer |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25275. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25275 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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