CPT 25575 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 | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25575 |
| Medicaid Fee Schedule | View Medicaid rates for 25575 |
National average reimbursement for CPT 25575 by major payers:
$1,208.64
$1,205.69
$1,294.09
$1,474.40
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 25575 | $8207.00 | 1639850415 - MEDICAL CITY SURGERY CENTER OF ALLEN, LLC | 932106228 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $3000.00 | 1598276404 - BALBOA NEPHROLOGY MEDICAL GROUP,INC., SAN DIEGO ACCESS AND SURGERY CENTER | 952848091 - (CA) BALBOA NEPHROLOGY MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $600.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1004.00 | 1033294640 - NORTHERN NEW JERSEY EYE INSTITUTE PA | 222489176 - (NJ) NORTHERN NEW JERSEY EYE INSTITUTE, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $8358.00 | 1629510326 - COLLEGE PARK ENDOSCOPY CENTER, LLC, COLLEGE PARK SURGERY CENTER | 474427740 - (KS) COLLEGE PARK ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $2992.00 | 1366422370 - URLOGY AMBULATORY SURGERY CENTER LLC, WOLF RIVER SURGERY CENTER | 621828958 - (TN) URLOGY AMBULATORY SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $4480.00 | 1770513855 - CAPITAL ENDOSCOPY LLC | 134244093 - (MD) CAPITAL ENDOSCOPY & SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $3796.00 | 1003575218 - RENAL FOCUS ASC LLC, RENAL FOCUS ASC PLAINVIEW | 863151108 - (NY) RENAL FOCUS ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $5963.00 | 1760907919 - BANNER SUN CITY WEST SURGERY CENTER LLC | 901182684 - (AZ) BANNER SUN CITY WEST SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1800.00 | 1023123296 - ASSOCIATES SURGERY CENTERS, LLC | 510492139 - (PA) ASSOCIATES SURGERY CENTERS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1088.00 | 1376692129 - STUART CARDON, CASCADE FOOT AND ANKLE PLLC | 205179809 - (WA) STUART CARDON DBA CASCADE FOOT & | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $4850.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $2807.00 | 1831117704 - MEDICAL HEIGHTS SURGERY CENTER, INC., KENTUCKY SURGERY CENTER | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $4000.00 | 1205885746 - GLASGOW MEDICAL CENTER LLC, GLASGOW AMBULATORY SURGERY CENTER | 510320926 - (DE) GLASGOW MEDICAL CENTER, LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $865.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | 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 25575 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25575 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 25575 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. |
| 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 |
| 25560-CPT | Moderate | Closed Treatment Of Radial And, Closed Treatment Of Radial And Ulnar Shaft Fractureswithout Manipulation Closed Treatment Of Radial And Ulnar Shaft Fractures |
| 25575-CPT | High | 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 25575. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25575 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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