How much does Medicare pay for CPT 25020?

Medicare allowed an average of $704.69 per service and paid $555.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2925.85, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Which specialty bills 25020 most?

Hand Surgery, with 631 services from 14 clinicians. Next are Orthopedic Surgery, Ambulatory Surgical Center, Plastic and Reconstructive Surgery.

CPT 25020

Incision of tissue of forearm and/or wrist muscle compartment on one side of the forearm to relieve pressure, without removal of tissue

$704.69Medicare-allowed amount per service, averaged across 1,349 services

Providers submitted

$2925.85

Asking price, not received

Medicare allowed

$704.69

The fee schedule figure

Medicare paid

$555.77

Balance is patient coinsurance

Providers submitted an average of $2925.85 for this code and Medicare allowed $704.69 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $555.77 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,349
Beneficiaries: 1,220
Providers billing it: 39
Total allowed: $950,627

What Medicare pays for CPT 25020

Across 1,349 services billed by 39 providers to 1,220 beneficiaries, Medicare allowed an average of $704.69 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 25020

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hand Surgery	631	567	$726.60	14
Orthopedic Surgery	412	374	$752.85	14
Ambulatory Surgical Center	184	165	$540.33	7
Plastic and Reconstructive Surgery	122	114	$676.62	4

25020 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	403	$730.30	$503.70	14
Pennsylvania	252	$694.96	$561.31	5
Texas	129	$718.91	$580.99	4
New York	121	$637.44	$447.57	4
Florida	111	$679.65	$522.88	2
Louisiana	77	$604.53	$538.91	2
Massachusetts	61	$758.09	$538.21	2
New Jersey	59	$737.21	$580.39	1
Connecticut	52	$820.01	$577.30	1
Mississippi	47	$625.78	$590.26	2
Illinois	25	$793.31	$571.24	1
Oklahoma	12	$641.90	$534.09	1

Related codes

25000Incision or the tendon covering on the top side of the wrist$377.65

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.