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See a sample rate comparisonCPT 25929 Fee Schedule
Last Verified: October 2026
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.
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| 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 AS - PA/NP/CNS assistant at surgery RT - Right side of body F2 - Left hand, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25929 |
| Medicaid Fee Schedule | View Medicaid rates for 25929 |
National average reimbursement for CPT 25929 by major payers:
$798.74
$790.69
$808.08
$972.62
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CPT 25929
5 of 25 sample ratesHigher to lower in this preview
Belleair Surgery Center Ltd
$5,532.00Published rateVenture Ambulatory Surgery Center LLC
$1,368.00Published rateNew Port Richey Surgery Center Ltd
$839.00Published rateAnmed Health Medicus Surgery Center LLC, Medicus Surgery Center, Inc.
Anmed Health Medicus Surgery Center, LLC
$584.00Published ratePonte Vedra Beach Surgery Center LLC
Surgical Center Of Ponte Vedra B
$330.00Published rate
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See a sample payer proposalCPT 25929 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25929 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 25929 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25929. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25929 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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