CPT 25520 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 25520 |
National average reimbursement for CPT 25520 by major payers:
$770.72
$755.56
$783.66
$965.40
| 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 25520 | ||||||
United | 25520 | $386.00 | 1326097981 - FREDERICKSBURG AMBULATORY SURGERY CENTER, LLC | 562322548 - (VA) FREDERICKSBURG AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $144.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $450.00 | 1316009194 - ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC, TINLEY WOODS SURGERY CENTER | 364437931 - (IL) ADVOCATE SOUTHWEST AMBULATORY SURGE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $574.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $927.00 | 1093731101 - EAST BRUNSWICK SURGERY CENTER LLC, UNIVERSITY SURGICENTER | 20593133 - (NJ) EAST BRUNSWICK SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $285.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $317.00 | 1588665269 - RF EYE PC, COCHISE EYE & LASER ASC | 860879991 - (AZ) R.F. EYE, PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $2347.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $235.00 | 1255875126 - VIP SURG ASC, LLC, VIP SURGICAL CENTER | 811621842 - (TX) VIP SURG ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $326.00 | 1093708315 - ASSOCIATED HEALTH SERVICES, INC., JAMES E DAVIS AMBULATORY SURGICAL CENTER | 561845329 - (NC) ASSOCIATED HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $2965.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $116.00 | 1871586149 - DISCOVER VISION SURGERY & LASER CENTER LLC, DISCOVER VISION SURGERY & LASER CENTER | 481244168 - (KS) DISCOVER VISION SURGERY LASER CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $371.00 | 1861041139 - KADLEC REGIONAL MEDICAL CENTER, KADLEC AMBULATORY ENDOSCOPY CENTER, LEE CAMPUS | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $120.00 | 1093726309 - INSIGHT SURGERY & LASER CENTER, LLC | 203458868 - (OH) INSIGHT SURGERY LASER CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25520 | $531.00 | 1154956928 - ADVANCED SURGICAL CARE OF CLEARWATER LLC | 833698204 - (FL) ADVANCED SURGICAL CARE OF CLEARWATER LLC | 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 25520 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25520 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 25520 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 |
| 25515-CPT | Moderate | Open Radial Shaft W/Wo Int/Ext Fix |
| 25520-CPT | Moderate | Closed Treatment Of Radial Shaft Fracture And Closed Treatment Of Dislocation Of Distal Radioulnar Joint (Galeazzi Fracture/Dislocation) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25520 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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