CPT 25392 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25392 |
National average reimbursement for CPT 25392 by major payers:

$1,438.07

$1,404.53

$1,403.18

$1,720.08
| 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 25392 | ||||||
United | 25392 | $4574.00 | 1619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | 800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $3570.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1226.00 | 1285120352 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1331.00 | 1811345267 - CAROLINAS AMBULATORY SURGERY INC., ATRIUM HEALTH SURGERY CENTER ROCK HILL | 812714217 - (SC) CAROLINAS AMBULATORY SURGERY INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1868.00 | 1144590332 - HEALTHCARE PARTNERS ASC-LB, LLC, DAVITA MEDICAL ASC | 954628842 - (CA) HEALTHCARE PARTNERS ASCLB LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1119.00 | 1548249675 - ENDOSCOPY CENTER OF SANTA FE LP, THE ENDOSCOPY CENTER OF SANTA FE | 621548645 - (NM) ENDOSCOPY CENTER OF SANTA FE LP | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $847.00 | 1518279504 - EVANS PROCEDURE CENTER, LLC | 272289325 - (GA) EVANS PROCEDURE CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $2080.00 | 1154724326 - BINZ SURGERY CENTER, LLC | 352484734 - (TX) BINZ SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1700.00 | 1881687614 - TURKS HEAD SURGERY CENTER LLC | 200184603 - (PA) TURK'S HEAD SURGERY CENTER, L.L.C. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1684.00 | 1386892230 - NORMAN ENDOSCOPY CENTER, LLC | 208716173 - (OK) NORMAN ENDOSCOPY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1800.00 | 1437102241 - SURGERY CENTER OF FREMONT, LLC | 203639614 - (NE) SURGERY CENTER OF FREMONT LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $4245.00 | 1376164475 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, RIDGEWOOD ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO | 742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $4140.00 | 1811995913 - DALLAS SURGICAL PARTNERS, LLC, BAYLOR SCOTT & WHITE SURGICARE | 752813815 - (TX) DALLAS SURGICAL PARTNERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1458.00 | 1023005600 - PSHS BETA PARTNERS LTD, THE GABLES SURGICAL CENTER | 650848650 - (FL) PSHS BETA PARTNERS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25392 | $1545.00 | 1730409400 - EYE BONE, LLC, CHARDON SURGERY CENTER | 204691851 - (OH) EYE BONE, LLC DBA CHARDON SURGERY CENTER | OH | 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 25392 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25392 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 25392 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25392. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25392 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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