CPT 25275 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 25275 by major payers:
$897.40
$902.86
$961.12
$1,131.20
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 25275 | ||||||
United | 25275 | $1512.00 | 1215307012 - BAY AREA SURGICENTER, LLC, BRANDON SURGERY CENTER | 474961128 - (FL) BAY AREA SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $2637.00 | 1437764321 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT PLANTATION | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $636.00 | 1235104738 - THE OVERLAND PARK KS ENDOSCOPY ASC LLC, ENDOSCOPIC IMAGING CENTER | 201635603 - (KS) THE OVERLAND PARK KS ENDOSCOPY ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1142.00 | 1578525853 - GASTROINTESTINAL CENTER OF HIALEAH, LLC | 650173048 - (FL) GASTROINTESTINAL CENTER OF HIALEAH LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1991.00 | 1073509733 - WEST PLAINS SURGERY CENTER LLC | 320093110 - (MO) WEST PLAINS AMBULATORY SURGERY CENT | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1890.00 | 1376228361 - SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | 923802390 - (OH) SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1750.00 | 1902438112 - SURGERY CENTER OF SAN DIEGO, LLC | 833107404 - (CA) SURGERY CENTER OF SAN DIEGO LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $2074.00 | 1275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1420.00 | 1285608075 - PUEBLO CO OPHTHALMOLOGY ASC LLC, ROCKY MOUNTAIN LASER & SURGERY CENTER | 200121336 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1194.00 | 1730132853 - OUTPATIENT SURGERY CENTER, INC. | 204305130 - (AR) OUTPATIENT SURGERY CENTER INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $3124.00 | 1730571118 - MEDSTAR MEDICAL GROUP | 462691028 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $2549.00 | 1770075467 - DRY CREEK SURGERY CENTER, LLC | 825264853 - (CO) DRY CREEK SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $1490.00 | 1427183664 - LAGRECA EYE CLINIC, P.C., THE EYE CLINIC SURGICENTER | 320016290 - LAGRECA EYE CLINIC, PC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $2071.00 | 1992707855 - VESC LLC, ADVENTHEALTH SURGERY CENTER ORMOND BEACH | 593415079 - (FL) VESC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25275 | $3347.00 | 1790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP | 810587498 - (AZ) METRO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 Tendon/Muscle Flexor Primary |
| 25274-CPT | Moderate | Repair, Tendon Or Muscle, Extensor, Forearm And/Or Wrist; Secondary, With Free Graft (Includes Obtaining Graft), Each Tendon Or Muscle |
| 25275-CPT | Moderate | Repair, Tendon Sheath, Extensor, Forearm And/Or Wrist, With Free Graft (Includes Obtaining Graft) (Eg, For Extensor Carpi Ulnaris Subluxation) |
| 25316-CPT | High | Reposit Flexor W Tendon 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 25275) and we'll show you how you compare in 15 minutes or less.