CPT 25315 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 25315 by major payers:
$1,147.12
$1,086.08
$1,082.54
$1,329.56
| 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 25315 | ||||||
United | 25315 | $2566.00 | 1700842507 - ARCADIA OUTPATIENT SURGERY CENTER LP | 752285078 - (CA) ARCADIA OUTPATIENT SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $734.00 | 1841304797 - SOUTH GEORGIA ENDOSCOPY CENTER, INC | 593737668 - (GA) SOUTH GEORGIA ENDOSCOPY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1800.00 | 1346213634 - SARASOTA ENDOSCOPY ASC LLC, BAYVIEW ENDOSCOPY CENTER | 621806248 - (FL) THE SARASOTA ENDOSCOPY ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1500.00 | 1215275227 - ISPM ASC AT PIEDMONT, LLC | 455109249 - (GA) ISPM ASC AT PIEDMONT LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1278.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1310.00 | 1902981558 - LANE SURGERY CENTER, LLC | 931305103 - (OR) LANE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $2460.00 | 1508197039 - FREEMAN SURGICAL CENTER LLC | 262652980 - (MO) FREEMAN SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $3570.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $6734.00 | 1487059002 - RIVERWALK ASC, LLC, RIVERWALK ASC | 472075991 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $3728.00 | 1255797726 - BLOOMFIELD ASC LLC | 474758895 - (CT) BLOOMFIELD ASC, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $2356.00 | 1912600826 - SURGICAL CENTER OF TVH | 882585662 - (ID) SURGICAL CENTER OF TVH | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1595.00 | 1518272087 - SIPI AMBULATORY SURGERY CENTER | 300638923 - (ID) SIPI AMBULATORY SURGERY CENTER | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $1600.00 | 1700974995 - THE NEW JERSEY CENTER FOR EAR, NOSE AND THROAT DISORDERS, P.C. | 202822342 - (NJ) THE NEW JERSEY CENTER FOR EAR NOSE AND THROAT DISORDERS PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $3623.00 | 1417377649 - PACIFIC ENDOSCOPY CENTER LLC | 203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLC | HI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25315 | $2809.00 | 1073944039 - THE POLYCLINIC, THE POLYCLINIC PLASTIC SURGERY CENTER | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | 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 |
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CPT 25315 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25315 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 25315 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 |
|---|---|---|
| 25312-CPT | Moderate | Tendon Transplantation Or Transfer, Flexor Or Extensor, Forearm And/Or Wrist, Single; With Tendon Graft(S) (Includes Obtaining Graft), Each Tendon |
| 25315-CPT | High | Flexor Origin Slide For Cerebral Palsy; |
| 25316-CPT | High | Reposit Flexor W Tendon Transfer |
| 25320-CPT | High | Capsulorrhaphy Or Reconstruction Wrist Open (Eg Capsulodesis Ligament Repair Tendon Trans Fer Or Graft) (Includes Synovectomy Capsulotomy And Open Reduction) For Carpal Instability (Desc Rev 1/1/03) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25315 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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