CPT 25574 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 25574 by major payers:
$946.90
$894.53
$940.70
$1,130.01
| 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 25574 | ||||||
United | 25574 | $8207.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $3070.00 | 1518450790 - VIRGINIA ENT SURGERY CENTER INC | 825301397 - (VA) VIRGINIA ENT SURGERY CENTER INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $4519.00 | 1821047499 - RIVERSIDE SURGERY CENTER, INC. | 680400319 - (CA) RIVERSIDE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $2500.00 | 1265519821 - SEVEN HILLS SURGERY CENTER LLC | 203044042 - SEVEN HILLS SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $2800.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $7666.00 | 1164776266 - UNIVERSITY OF KANSAS HOSPITAL | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $2121.00 | 1467415513 - LAS VEGAS SURGICARE LTD | 880244070 - (NV) LAS VEGAS SURGICARE LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $6087.00 | 1144287665 - CHANNEL ISLANDS SURGICENTER LP | 770418197 - (CA) CHANNEL ISLANDS SURGICENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $1975.00 | 1568583896 - EASTERN ORANGE AMBULATORY SURGERY CENTER, LLC | 205350007 - (NY) EASTERN ORANGE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $6588.00 | 1558794081 - SURGERY CENTER OF SCOTTSDALE, LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $3000.00 | 1700389822 - CENTER FOR SPINE INTERVENTIONS ASC 2 | 813634134 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $4000.00 | 1972508174 - VILLAGE SURGICENTER, LIMITED PARTNERSHIP, VILLAGE SURGICENTER OF ERIE | 760555703 - (PA) VILLAGE SURGICENTER LIMITED PARTNERSHIP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $5800.00 | 1396784252 - FRONTENAC AMBULATORY SURGERY & SPINE CARE CENTER LP, FRONTENAC SURGERY & SPINE CARE CENTER | 205953268 - (MO) FRONTENAC AMBULATORY SURGERY SPINE CARE CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $5020.00 | 1154959179 - MUNSTER SURGERY CENTER LLC | 844828519 - (IN) MUNSTER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $7888.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | 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 25574 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25574 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 25574 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 |
|---|---|---|
| 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) |
| 25526-CPT | High | 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 |
| 25574-CPT | Moderate | Open Rad/Ulna Shaft Fix Rador Ulna |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25574. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25574 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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