CPT 25505 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25505 |
National average reimbursement for CPT 25505 by major payers:
$671.71
$668.33
$711.78
$853.82
| 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 25505 | ||||||
United | 25505 | $331.00 | 1871811257 - HILLSIDE ENDOSCOPY CENTER, LLC | 263741464 - (PA) HILLSIDE ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $379.00 | 1326091513 - PAIN TREATMENT CENTERS OF MICHIGAN LLC, MATRIX SURGERY CENTER | 770623438 - (MI) PAIN TREATMENT CENTERS OF MICHIGAN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $500.00 | 1932309341 - HERNDON SURGERY CENTER, INC. | 461297783 - (CA) FRESNO CA MULTI ASC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $428.00 | 1790269462 - BARBOUR ORTHOPAEDICS SURGERY CENTER, LLC | 822423698 - (GA) BARBOUR ORTHOPAEDICS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $285.00 | 1871644823 - PERLOW FACILITY, LLC | 251926011 - (GA) PERLOW FACILITY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $445.00 | 1740287168 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $530.00 | 1659338382 - STERLING SURGICAL CENTER, LLC | 161607894 - (NY) STERLING SURGICAL CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $328.00 | 1093716037 - CATARACT AND REFRACTIVE SURGERY CENTER, LLC, NOVAMED SURGERY CENTER OF RICHMOND, LLC | 621865972 - (VA) CATARACT AND REFRACTIVE SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $416.00 | 1588329098 - GHS SERVICES, LLC, GASTRO SOUTH ENDOSCOPY CENTER | 854238832 - (GA) GHS SERVICES LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $624.00 | 1639618036 - PRESENCE LAKESHORE GASTROENTEROLOGY, LLC | 811750563 - (IL) PRESENCE LAKESHORE GASTROENTEROLOGY LLC DBA DES PLAINES ENDOSCOPY CENT | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $967.00 | 1841626090 - COLUMBUS ENDOSCOPY CENTER LLC | 463368948 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $264.00 | 1033760723 - ADVANCED SURGERY CENTER OF OXFORD | 825522826 - (FL) OXFORD SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $675.00 | 1881225639 - BANNER SURGERY CENTER | 843441285 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $450.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25505 | $250.00 | 1396454963 - ST LUKES SURGICAL CENTER INC, ST. LUKE'S SURGICAL AT WESLEY CHAPEL | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | 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 25505 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25505 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 25505 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 |
|---|---|---|
| 25500-CPT | Moderate | Tx Closed Radial Shaft Fx;W/O Manipulati |
| 25505-CPT | Moderate | Close Radial Shaft Fract W Manip |
| 25520-CPT | Moderate | Closed Treatment Of Radial Shaft Fracture And Closed Treatment Of Dislocation Of Distal Radioulnar Joint (Galeazzi Fracture/Dislocation) |
| 25525-CPT | High | Open Treatment Of Radial Shaft Fracture, Includes Internal Fixation, When Performed, And Closed Treatment Of Distal Radioulnar Joint Dislocation (Galeazzi Fracture/ Dislocation), Includes Percutaneous Skeletal Fixation, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25505 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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