CPT 25600 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 | • 11 - Office • 23 - Emergency Room |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 25600 by major payers:
$422.37
$423.87
$469.16
$555.90
| 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 25600 | ||||||
United | 25600 | $1016.00 | 1720543481 - SURGICAL SUITES OF COASTAL VIRGINIA, LLC | 833205375 - (VA) SURGICAL SUITES OF COASTAL VIRGINIA LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $93.00 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $174.00 | 1932430816 - SURGCENTER OF GREENBELT, LLC | 270408064 - (MD) SURGCENTER OF GREENBELT LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $566.00 | 1780128553 - CAROLINAS ENDOSCOPY CENTER LLC | 814599818 - CAROLINAS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $573.69 | 1730528944 - ADAM WADLINGTON | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 25600 | $73.00 | 1275740839 - EYE SURGERY CENTER OF NORTH FLORIDA LLC | 205326854 - (FL) EYE SURGERY CENTER OF NORTH FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $100.00 | 1659451078 - ACADEMY ORTHOPEDICS, LLC, DBA ACADEMY ORTHOPEDICS, LLC, AMBULATORY SURGICAL CENTER | 582383939 - (GA) ACADEMY ORTHOPEDICS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $230.00 | 1639605595 - QUEEN CREEK SURGICAL CENTER, LLC | 821292127 - (AZ) QUEEN CREEK SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $115.00 | 1639650161 - TRAILS EDGE SURGERY CENTER, LLC | 831528858 - (FL) TRAILS EDGE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $455.00 | 1265495451 - EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC | 141819770 - (NY) EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $230.00 | 1881339133 - BSC SHEA PARK LLC | 881850069 - (AZ) BSC SHEA PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $746.00 | 1780853044 - HACIENDA SURGERY CENTER, LLC | 320439356 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $850.00 | 1508276080 - OHIO SPECIALTY SURGICAL SUITES, LLC | 464078247 - (OH) OHIO SPECIALTY SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $140.00 | 1447212337 - PUGET SOUND GASTROENTEROLOGY, PLLC, EVERGREEN ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $91.00 | 1316375884 - OXON HILL UROLOGY SURGERY CENTER PC | 463746777 - (MD) OXON HILL UROLOGY SURGERY CENTER PC | MD | 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 25600 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25600 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 25600 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 |
|---|---|---|
| 25600-CPT | Moderate | Closed Treatment Of Distal Radial Fracture (Eg, Colles Or Smith Type) Or Epiphyseal Separation, Includes Closed Treatment Of Fracture Of Ulnar Styloid, When Performed; Without Manipulation |
| 25605-CPT | Moderate | Closed Treatment Of Distal Radial Fracture (Eg, Colles Or Smith Type) Or Epiphyseal Separation, Includes Closed Treatment Of Fracture Of Ulnar Styloid, When Performed; With Manipulation |
| 25606-CPT | Moderate | Percutaneous Skeletal Fixation Of Distal Radial Fracture Or Epiphyseal Separation |
| 25607-CPT | High | Open Treatment Of Distal Radial Extra Articular Fracture Of Epiphyseal Separation With Internal Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25600. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25600 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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