CPT 25320 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25320 |
National average reimbursement for CPT 25320 by major payers:
$1,352.82
$1,311.22
$1,413.16
$1,652.26
| 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 25320 | ||||||
United | 25320 | $5433.00 | 1851950281 - YUMA ADVANCED SURGICAL SUITES LLC | 833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $8825.00 | 1407165772 - MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY, LLC, MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY | 273520409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $2200.00 | 1659574283 - PROVIDENCE VENTURES, LLC, BONE AND JOINT SURGERY CENTER OF NOVI | 161704029 - (MI) PROVIDENCE VENTURES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $741.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $3200.00 | 1780789024 - LINDEN SURGICAL CENTER, LLC | 223634504 - (NJ) LINDEN SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $2090.00 | 1184689408 - EVERGREEN EYE CENTER, PLLC, EYE ASSOCIATES NORTHWEST SURGERY CENTER | 911610832 - (WA) EYE ASSOCIATES NORTHWEST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $3935.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $5354.00 | 1346383155 - BRIARCLIFF AMBULATORY SURGERY CENTER LP, BRIARCLIFF SURGERY CENTER | 202852584 - (MO) BRIARCLIFF AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $5433.00 | 1902807159 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $1665.00 | 1427017813 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PENINSULA ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $4000.00 | 1356969703 - VASCULAR LABS OF THE ROCKIES ASC, LLC | 850780051 - (CO) VASCULAR LABS OF THE ROCKIES ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $830.00 | 1407992878 - WILSON COUNTY EYE SURGERY CENTER, LLC | 621714950 - (TN) WILSON COUNTY EYE SURGERY CENTER, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $2060.00 | 1376546721 - DULANEY EYE INSTITUTE, LLC | 521886840 - (MD) DULANEY EYE INSTITUTE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $3690.00 | 1790876431 - MAIN LINE SPINE SURGERY CENTER, LLC | 202547795 - (PA) MAIN LINE SPINE SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25320 | $1088.00 | 1851516728 - PHOENIX ENDOSCOPY LLC | 710940187 - (AZ) PHOENIX ENDOSCOPY 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 |
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CPT 25320 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25320 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 25320 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 25320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25320 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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