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See a sample rate comparisonCPT 25526 Fee Schedule
Last Verified: October 2026
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.
Treat Fracture Of Radius, Open Treatment Of Radial Shaft Fracture Includes Internal Fixation When Performed And Open Treatment Of Distal Radioulnar Joint Dislocation Galeazzi Fracture Dislocation Includes Internal Fixation When Performed Includes Repair Of Triangular Fibrocartilage Complex
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25526 |
| Medicaid Fee Schedule | View Medicaid rates for 25526 |
National average reimbursement for CPT 25526 by major payers:
$1,255.03
$1,315.21
$1,340.12
$1,588.02
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CPT 25526
5 of 25 sample ratesHigher to lower in this preview
Memorial Care Surgical Center At Orange Coast, LLC
Memorial Care Surgical Center At Orange Coast LLC
$14,316.00Published rateBismarck Sinus Center
$4,932.00Published rateThe Surgical Center Of The Treasure Coast, LLC
Surgical Center Of The Treasure Coast
$3,489.00Published rateEvergreen Eye Center, PLLC, Eye Associates Northwest Surgery Center
Eye Associates Northwest, PLLC
$2,681.00Published rateAndre J Golino Md And Associates PA, Palm Beach Eye Clinic
Andre J Golino Md And Associates PA
$875.00Published rate
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See a sample payer proposalCPT 25526 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25526 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 25526 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 |
|---|---|---|
| 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 |
| 25525-CPT | High | Treat Fracture Of Radius, 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 |
| 25526-CPT | High | Treat Fracture Of Radius, Open Treatment Of Radial Shaft Fracture Includes Internal Fixation When Performed And Open Treatment Of Distal Radioulnar Joint Dislocation Galeazzi Fracture Dislocation Includes Internal Fixation When Performed Includes Repair Of Triangular Fibrocartilage Complex |
| 25574-CPT | Moderate | Surgery To Repair Broken Arm, Surgery To Repair Broken Bones In The Lower Arm (Radius And Ulna). Pins Wires Or Screws Are Used To Hold One Or Both Bones Together. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25526. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25526 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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