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 |
| Medicare Fee Schedule | View Medicare rates for 25600 |
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 | $93.00 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $1708.00 | 1689639692 - SURGICAL CENTER OF SOUTH JERSEY LIMITED PARTNERSHIP | 222709324 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $193.00 | 1871915041 - SURGICAL EYE CENTER OF SAN ANTONIO | 460591036 - (TX) SURGICAL EYE CENTER OF SAN ANTONIO | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $72.00 | 1043367196 - SURGICAL SPECIALISTS GROUP, LLC, ALABAMA OUTPATIENT SURGERY CENTER | 201398879 - (AL) SURGICAL SPECIALISTS GROUP, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $172.00 | 1063495257 - DOCTORS SURGICAL PARTNERSHIP LLC, MELBOURNE SAME DAY SURGERY | 593490279 - (FL) DOCTORS SURGICAL PARTNERSHIP LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $1397.00 | 1649482449 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $77.00 | 1194790808 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $512.00 | 1942299441 - PAIN CARE OF NORTH TEXAS, LLC | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $573.69 | 1659351419 - JASON MECKLER | 350593390 - DEACONESS HOSPITAL INC | IN | Neurology Physician (2084N0400X) |
United | 25600 | $66.00 | 1740283837 - WESTERN MARYLAND SURGICENTER LLP | 521957544 | MD | 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 | $574.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $100.00 | 1740944487 - ADVANCED AMBULATORY SURGERY CENTER LLC | 822160115 - (KS) ADVANCED AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25600 | $482.00 | 1710904701 - ENDOSCOPIC DIAGNOSTIC & TREATMENT CENTER LLC | 770611981 - (NY) ENDOSCOPIC DIAGNOSTIC TREATMENT CENTER LLC | NY | 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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