CPT 25525 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 25525 by major payers:
$1,060.67
$1,085.62
$1,100.64
$1,350.39
| 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 25525 | ||||||
United | 25525 | $5963.00 | 1437615929 - BANNER ENTICARE TEMPE SURGERY CENTER LLC, BANNER TEMPE SURGERY CENTER | 833567835 - (AZ) BANNER ENTICARE TEMPE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $680.00 | 1528035367 - EYE SURGERY CENTER OF WESTERN OHIO LLC, EYE SURGERY CENTER OF WESTERN OHIO | 311570796 - (OH) EYE SURGERY CENTER OF WESTERN OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $1325.00 | 1912388026 - SURGICAL CENTER OF PEAK ENDOSCOPY, LLC | 473704021 - (CO) SURGICAL CENTER OF PEAK ENDOSCOPY LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $8358.00 | 1962277483 - KC SURGICENTER, LLC | 372003878 - (MO) KC SURGICENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $3454.00 | 1750169975 - UNOVA ASC, INC | 812495096 - (FL) UNOVA ASC INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $3555.00 | 1740385632 - GULF COAST OUTPATIENT SURGERY CENTER LLC, GULF COAST OUTPATIENT SURGERY CENTER | 640935301 - (MS) GULF COAST OUTPATIENT SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $2193.00 | 1427017813 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PENINSULA ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $3382.00 | 1497733661 - CHEVY CHASE AMBULATORY CENTER LP | 432003978 - (CA) CHEVY CHASE AMBULATORY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $3182.00 | 1396719563 - BAPTIST GERMANTOWN SURGERY CENTER, LLC, BAPTIST GERMANTOWN SURGERY CENTER | 621829424 - (TN) BAPTIST GERMANTOWN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $6588.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $6492.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $4170.00 | 1528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER | 450516750 - (NJ) VANTAGE SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $1020.00 | 1619166097 - GPDDC, LLC | 43769350 - (NY) GPDDC, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $4134.00 | 1699054098 - SURGCENTER OF WESTERN MARYLAND, LLC | 272969860 - (MD) SURGCENTER OF WESTERN MARYLAND, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25525 | $1967.00 | 1255872784 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER | 814079161 | PA | 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 25525 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25525 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 25525 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 |
| 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 25525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25525 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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