CPT 20525
Global 010 ActiveRmvl fb musc/tdn deep/comp
CPT 20525 Billing & Documentation Guide
CPT code 20525 (Rmvl fb musc/tdn deep/comp) is classified under Surgery (Musculoskeletal) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.45, a non-facility practice expense RVU of 10.77, and a malpractice RVU of 0.66, a total non-facility RVU of 14.88 and facility RVU of 6.98. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $511.88, though rates vary from $435.59 to $658.45 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 20525, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 20525 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 4 units of 20525 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 20525
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.45 | 3.45 |
| Practice Expense RVU | 10.77 | 2.87 |
| Malpractice RVU | 0.66 | 0.66 |
| Total RVU | 14.88 | 6.98 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 20525
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $556.97 | $244.75 | $523.27 - $658.45 | 29 |
| Florida | $519.07 | $254.33 | $492.27 - $545.46 | 3 |
| Georgia | $484.97 | $233.24 | $462.39 - $507.54 | 2 |
| Illinois | $505.35 | $250.39 | $478.12 - $528.16 | 4 |
| Michigan | $484.05 | $236.27 | $468.55 - $499.54 | 2 |
| North Carolina | $464.95 | $218.76 | $464.95 - $464.95 | 1 |
| New York | $551.98 | $257.61 | $472.47 - $591.26 | 5 |
| Ohio | $465.89 | $224.97 | $465.89 - $465.89 | 1 |
| Pennsylvania | $492.19 | $233.74 | $466.3 - $518.08 | 2 |
| Texas | $490.5 | $230.72 | $463.06 - $515.59 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 20525
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 20525 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0718T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 20525
What does CPT code 20525 mean? +
CPT code 20525 represents: Rmvl fb musc/tdn deep/comp. It's in the Surgery (Musculoskeletal) category with a global period of 010.
What is the Medicare reimbursement for CPT 20525? +
The 2026 Medicare national average non-facility payment for CPT 20525 is $511.88. Rates range from $435.59 to $658.45 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 20525? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 20525? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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