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 |
National average reimbursement for CPT 25575 by major payers:
$1,208.64
$1,205.69
$1,294.09
$1,511.49
| 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 25575 | ||||||
United | 25575 | $1800.00 | 1023123296 - ASSOCIATES SURGERY CENTERS, LLC | 510492139 - (PA) ASSOCIATES SURGERY CENTERS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1947.00 | 1336143734 - TORRANCE ENDOSCOPY AND SURGICAL AFFILIATES, INC, ENDOSCOPY CENTER AT SKYPARK | 954871082 - (CA) TORRANCE ENDOSCOPY AND SURGICAL AFFILIATES INC | CA | 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 | $3406.00 | 1558926931 - WELLNESS AMBULATORY SURGERY CENTER, LLC | 810848308 - (TX) WELLNESS AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1530.00 | 1689910739 - THE ENDOSCOPY CENTER AT BAINBRIDGE, LLC, UNIVERSITY SUBURBAN ENDOSCOPY CENTER | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1956.00 | 1295766202 - MCGEE EYE SURGERY CENTER LLC | 621600425 - (OK) MCGEE EYE SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $1500.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $5499.00 | 1396832549 - GENESEE CARE L.L.C., THE SURGERY CENTER OF GENESEE COUNTY | 383242685 - (MI) GENESEE CARE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $862.00 | 1376592204 - PALMETTO ENDOSCOPY CENTER LLC | 571195554 - (SC) PALMETTO ENDOSCOPY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $9000.00 | 1790721769 - SAN FRANCISCO SURGERY CENTER, LP | 870689493 - (CA) SAN FRANCISCO SURGERY CENTER, LP | CA | 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 | $7254.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $3800.00 | 1174571970 - DCR SURGERY CENTER, LLC | 200019313 - (OH) DCR SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25575 | $7959.00 | 1619974219 - ST. JOSEPH'S SURGERY CENTER LP | 201019390 - (CA) ST JOSEPHS SURGERY CENTER LP | CA | 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 | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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 | Open Radial Shaft W/Wo Int/Ext Fix |
| 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 |
| 25560-CPT | Moderate | Close Rad/Ulna Shaft Wo Manip |
| 25575-CPT | High | Open Rad/Ulna Shaft Fix Rad & Ulna |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 25575) and we'll show you how you compare in 15 minutes or less.