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See a sample rate comparisonCPT 25455 Fee Schedule
Last Verified: October 2026
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.
Epiphyseal Arrest By Epiphysio, Epiphyseal Arrest By Epiphysiodesis Or Stapling Distalradius And Ulna Epiphyseal Arrest By Epiphysiodesis Or Stapling Distal
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25455 |
| Medicaid Fee Schedule | View Medicaid rates for 25455 |
National average reimbursement for CPT 25455 by major payers:
$996.64
$970.81
$990.26
$1,184.70
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CPT 25455
5 of 25 sample ratesHigher to lower in this preview
Baycare Aurora Kaukauna Surgery Center LLC, Kaukauna Surgery Center
Baycare Aurora Kaukauna Surgery Center LLC
$11,972.00Published rateLancaster Specialty Surgery Center
Lancaster Specialty Surgical Center
$3,700.00Published rateRocky Mountain Surgery Center LLC
Rocky Mountain Surgery Center, LLC
$2,781.00Published rateSani Eye Center, Inc., Sani Eye Surgery Center
Sani Eye Center Inc
$1,664.00Published rateNorth Pinellas Surgery Center LLC
North Pinellas Surgery Center, LLC
$680.00Published rate
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See a sample payer proposalCPT 25455 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25455 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 25455 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 |
|---|---|---|
| 25450-CPT | Moderate | Epiphyseal Arrest By Epiphysio, Epiphyseal Arrest By Epiphysiodesis Or Stapling Distalradius Or Ulna Epiphyseal Arrest By Epiphysiodesis Or Stapling Distal |
| 25455-CPT | Moderate | Epiphyseal Arrest By Epiphysio, Epiphyseal Arrest By Epiphysiodesis Or Stapling Distalradius And Ulna Epiphyseal Arrest By Epiphysiodesis Or Stapling Distal |
| 25490-CPT | High | Secure Bone To Prevent Break, Treatment To Prevent A Break In One Or Both Bones Of The Lower Arm (Radius Or Ulna). The Bone Is Stabilized With Pins Plates Nails Or Wire. |
| 25491-CPT | High | Secure Bone To Prevent Break, Treatment To Prevent A Break In One Or Both Bones Of The Lower Arm (Radius Or Ulna). The Bone Is Stabilized With Pins Plates Nails Or Wire. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25455 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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