CPT 24685 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 24685 |
| Medicaid Fee Schedule | View Medicaid rates for 24685 |
National average reimbursement for CPT 24685 by major payers:
$915.14
$884.96
$941.94
$1,082.16
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 24685 | $3850.00 | 1376269324 - THE SURGEON'S POINT SURGERY CENTER, LLC, THE SURGEON'S POINT AT CEDAR PARK | 301282509 - (TX) THE SURGEONS POINT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $6492.00 | 1548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER | 912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $1892.00 | 1952648966 - WENATCHEE VALLEY HOSPITAL, CONFLUENCE HEALTH OMAK ASC | 455563741 - WENATCHEE VALLEY HOSPITAL | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $2575.00 | 1942292073 - SOUTHERN OKLAHOMA SURGICAL CENTER INC | 731205988 - (OK) SOUTHERN OKLAHOMA SURGICAL CENTER, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $6588.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $4234.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $3200.00 | 1588994685 - SOUTHEASTERN INTERVENTIONAL PAIN ASC LLC | 271651377 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $1645.00 | 1831665983 - WAXAHACHIE SURGERY CENTER | 831268553 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $1644.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $1030.00 | 1366032617 - EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER, LLC | 843673604 - (MA) EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $3669.00 | 1598349839 - NAADI MANTECA ASC | 863449917 - (CA) NAADI MANTECA ASC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $6087.00 | 1720325160 - SURGCENTER OF DEER VALLEY, LLC | 461512703 - (AZ) SURGCENTER OF DEER VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $8087.00 | 1598096802 - MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC, MEMORIAL HERMANN MEMORIAL VILLAGE SURGERY CENTER | 264276930 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $2993.00 | 1558475210 - SURGICAL SPECIALTY ASSOCIATES LLC, DOCTORS SAME DAY SURGERY CENTER LLC | 721459017 - (LA) SURGICAL SPECIALTY ASSOCIATES | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24685 | $6492.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | 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 24685 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 24685 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 24685 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 |
|---|---|---|
| 24670-CPT | Moderate | Immobilize A Broken Elbow, Treatment To Immobilize A Broken Bone Of The Lower Arm (Ulna) Using A Splint Brace Or Cast. The Bone May Be Moved Into Place Manually. |
| 24675-CPT | Moderate | Immobilize A Broken Elbow, Treatment To Immobilize A Broken Bone Of The Lower Arm (Ulna) Using A Splint Brace Or Cast. The Bone May Be Moved Into Place Manually. |
| 24685-CPT | Moderate | Surgery To Repair Broken Elbow, Surgery To Repair A Broken Elbow Involving One Of The Two Lower Arm Bones (Radius Ulna). Pins Wires Screws Or An Implant May Be Used To Secure The Bones. |
| 24999-CPT | High | Upper Arm Or Elbow Surgery, Surgery Performed On Upper Arm Or Elbow. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24685 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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