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See a sample rate comparisonCPT 25316 Fee Schedule
Last Verified: September 2026
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.
Revise Palsy Hand Tendon S, Flexor Origin Slide Eg For Cerebral Palsy Volkmann Contracture Forearm And Or Wrist With Tendon S Transfer
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25316 |
| Medicaid Fee Schedule | View Medicaid rates for 25316 |
National average reimbursement for CPT 25316 by major payers:
$1,269.00
$1,275.66
$1,255.29
$1,529.38
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CPT 25316
5 of 25 sample ratesHigher to lower in this preview
Saint Vincent Hlth Ctr Spu
Highmark Health
$18,799.47Published rateSaint Thomas Campus Surgicare Lp
$6,020.00Published rateEye Mds Of Puget Sound PLLC, Narrows Eye Surgery Center
Eye M.D.S Of Puget Sound, PLLC
$3,449.00Published rateDenver Eye Surgery Center, LLC
Denver Eye Surgery Center LLC
$2,015.00Published rateWinter Haven Sebring Fl Ophthalmology Asc LLC, Eye Surgery & Laser Center
$905.00Published rate
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See a sample payer proposalCPT 25316 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25316 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 25316 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 |
|---|---|---|
| 25315-CPT | High | Release Tendon Contraction, Surgery To Release A Contracted Tendon That Is Causing The Lower Arm And/Or Wrist To Bend Unnaturally Or Deform. |
| 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 |
| 25320-CPT | High | Repair Revise Wrist Joint, Capsulorrhaphy Or Reconstruction Wrist Open Eg Capsulodesis Ligament Repair Tendon Transfer Or Graft Includes Synovectomy Capsulotomy And Open Reduction For Carpal Instability |
| 25335-CPT | High | Centralization Wrist On Ulna-Eg,Radial C |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25316 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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