CPT 25830 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25830 |
National average reimbursement for CPT 25830 by major payers:
$1,305.64
$1,305.34
$1,372.68
$1,687.71
| 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 25830 | ||||||
United | 25830 | $5355.00 | 1386647527 - ORTHOPEDIC SURGERY CENTER OF OC LLC | 330841806 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $5020.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $1743.00 | 1831413772 - OXFORD UROCARE PLLC | 272032475 - (MS) OXFORD UROCARE PLLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3127.00 | 1831576891 - ADVANCED SURGERY CENTER PERIMETER, LLC | 473080613 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $2836.00 | 1346988870 - E-ASC LLC, BEACON EVENDALE SURGICAL CENTER | 882263306 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3000.00 | 1518129576 - USC AMBULATORY SURGICAL CENTER PROF LLC | 208907202 - (SD) USC AMBULATORY SURGICAL CENTER PROF LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $2776.00 | 1326374844 - CREEKSIDE SURGERY SUITE | 680319558 - (CA) SHAHRIAR MABOURAKH, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $4234.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $8886.00 | 1659793891 - INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC | 461955980 - (VA) INOVA AMBULATORY SURGERY CENTER AT LORTON LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3300.00 | 1245759356 - DALLAS ASC, LLC, NORTH PARK HEART & VASCULAR SURGERY CENTER | 823468320 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3792.00 | 1760533830 - GASTROINTESTINAL MEDICAL CENTER ASC | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $2958.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3365.00 | 1851029060 - COLORADO SPRINGS SURGICENTER, LLC | 862813124 - COLORADO SPRINGS SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $4091.00 | 1356572465 - ORCHARD CREEK SURGERY CENTER, ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25830 | $3405.00 | 1437106846 - ANTIETAM UROSURGICAL CENTER LLC ASC | 522006832 - (MD) ANTIETAM UROSURGICAL CENTER LLC ASC | 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 25830 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25830 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 25830 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 |
|---|---|---|
| 25800-CPT | Moderate | Arthrodesis, Wrist; Complete, Without Bone Graft (Includes Radiocarpal And/Or Intercarpal And/Or Carpometacarpal Joints) |
| 25810-CPT | High | Arthrodesis, Wrist Joint (Including Radiocarpal And/Or Ulnocarpal Fusion); With Iliac Or Other Autograft (Includes Ob |
| 25820-CPT | Moderate | Fusion Intercarpal Wo Bone Graft |
| 25830-CPT | High | Arthrodesis, Distal Radioulnar Joint With Segmental Resection Of Ulna, With Or Without Bone Graft (Eg, Sauve-Kapandji Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25830 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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