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See a sample rate comparisonCPT 25574 Fee Schedule
Last Verified: October 2026
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.
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.
| 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
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CPT 25574
5 of 25 sample ratesHigher to lower in this preview
Franciscan Orthopedic Surgery Center LLC
$11,797.00Published ratePrince Frederick Surgery Center LLC
Prince Frederick Surgery Center, LLC
$6,492.00Published rateTeaneck Surgical Center, LLC
Teaneck Surgical Center LLC
$5,262.00Published rateOlol Pontchartrain Surgery Center, LLC, Our Lady Of The Lake Pontchartrain Surgery Center
Olol Pontchartrain Surgery Cente
$3,475.00Published rateNortheast Ambulatory Center Inc
Northeast Ambulatory Center, Inc.
$707.00Published rate
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See a sample payer proposalCPT 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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