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See a sample rate comparisonHealthcare 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 |
| Medicaid Fee Schedule | View Medicaid rates for 25520 |
National average reimbursement for CPT 25520 by major payers:

$770.72

$755.56

$783.66

$929.91
Choose a payer to see a sample of rates for CPT 25520.
Countryside Surgery Center Ltd
Kadlec Regional Medical Center
Discover Vision Surgery Laser Center LLC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 | Closed Treatment Of Radial Sha, Closed Treatment Of Radial Shaft Fracture Withoutmanipulation Closed Treatment Of Radial Shaft Fracture Without |
| 25505-CPT | Moderate | Closed Treatment Of Radial Sha, Closed Treatment Of Radial Shaft Fracture With Manipulationclosed Treatment Of Radial Shaft Fracture With Manipulation |
| 25515-CPT | Moderate | Repair And Secure Arm Break, Surgery To Repair A Broken Lower Arm Bone (Radius). The Broken Bone May Be Stabilized With Wires Pins Plates Or Screws. |
| 25520-CPT | Moderate | Closed Treatment Of Radial Sha, Closed Treatment Of Radial Shaft Fracture With Dislocation Of Distal Radio-Ulnar Joint (Galeazzi Fracturedislocation) Closed Treatment Of Radial Shaft Fracture With 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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