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 |
| Medicare Fee Schedule | View Medicare rates for 25574 |
| Medicaid Fee Schedule | View Medicaid rates for 25574 |
National average reimbursement for CPT 25574 by major payers:
$946.90
$894.53
$940.70
$1,101.26
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 25574 | $2266.00 | 1073588646 - ESCONDIDO CA ENDOSCOPY ASC LP, PARKWAY ENDOSCOPY CENTER | 201627039 - (CA) ESCONDIDO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $6588.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $5019.00 | 1720324296 - MT OGDEN UTAH SURGICAL CENTER LLC | 371705271 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $4227.00 | 1114584786 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $11797.00 | 1609549039 - FRANCISCAN ORTHOPEDIC SURGERY CENTER LLC | 845101253 - (IN) FRANCISCAN ORTHOPEDIC SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $3836.00 | 1821249616 - LINCOLN SURGERY CENTER LLC | 261790900 - (CO) LINCOLN SURGERY CENTER, LLC | CO | 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 | $6492.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $3069.00 | 1518070879 - EHLERS EYE SURGERY LLC | 270079770 - (WA) EHLERS EYE SURGERY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $1937.00 | 1407851090 - WICHITA FALLS ENDOSCOPY CENTER | 200474975 - (TX) WICHITA FALLS ENDOSCOPY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $2295.00 | 1679556864 - DOCTORS GI PARTNERSHIP LTD, HF SURGERY CENTER AT BABCOCK | 593758988 - (FL) DOCTORS GI PARTNERSHIP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $5262.00 | 1841444593 - TEANECK SURGICAL CENTER, LLC | 10776897 - (NJ) TEANECK SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $4309.00 | 1316379647 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, MINNESOTA EYE LASER & SURGERY CENTERS | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25574 | $6365.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | 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 | 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 |
| 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 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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