CPT 25900 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25900 |
National average reimbursement for CPT 25900 by major payers:
$1,018.29
$989.81
$989.70
$1,224.33
| 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 25900 | ||||||
United | 25900 | $1854.00 | 1558328518 - BUTLER AMBULATORY SURGERY CENTER L L C | 61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $2245.00 | 1124664198 - ADVANCED SURGICAL CARE EAST LLC | 833657018 - (AZ) ADVANCED SURGICAL CARE EAST LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $5963.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $8087.00 | 1184922353 - PEARLAND SURGERY CENTER, LLC | 270289493 - (TX) PEARLAND SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $2331.00 | 1063445542 - TOTAL PAIN CARE LLC | 202484443 - (MS) TOTAL PAIN CARE, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $901.00 | 1083638647 - WEST DES MOINES AMBULATORY SURGICAL CENTER LLC, WESTOWN AMBULATORY CENTER | 421469883 - (IA) WEST DES MOINES AMBULATORY SURGICAL CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $7888.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $3836.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $3042.00 | 1114291440 - PREMIER ASC LLC, PREMIER ORTHOPAEDIC SURGERY CENTER | 352433859 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $2784.00 | 1841368867 - DUBLIN EYE SURGERY CENTER LLC | 202788445 - (GA) DUBLIN EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $7812.00 | 1730834730 - HERITAGE DEVELOPMENT PARTNERS, LLC, ORTHOPAEDIC SURGERY CENTER | 882720151 - (KY) HERITAGE DEVELOPMENT PARTNERS LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $2796.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $5455.00 | 1760568273 - WALLA WALLA CLINIC, INC., WALLA WALLA CLINIC AMBULATORY SURGERY CENTER | 910862542 - WALLA WALLA CLINIC, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $1521.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 25900 | $3060.00 | 1194233189 - CHAPIN ORTHOPEDIC SURGERY CENTER | 473916029 - (SC) CHAPIN ORTHOPEDIC SURGERY CENTER | SC | 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 25900 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25900 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 25900 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) |
| 25900-CPT | High | Amputate Forearm-Thru Radius + Ulna |
| 25905-CPT | High | Amputation Forearm; Open Circular Guill |
| 25907-CPT | Moderate | Amputate Forearm-2nd Closure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25900 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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