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See a sample rate comparisonCPT 25394 Fee Schedule
Medicare rates as of October 2026
CPT 25394 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Osteoplasty, Carpal Bone, Shortening
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $735.49 national non-facility rate (2026)View Medicare rates for 25394 |
| Medicaid Fee Schedule | $586.02 median of the 8 states in the free previewView Medicaid rates for 25394 |
National average reimbursement for CPT 25394 by major payers:
$1,026.18
BCBS / Anthem
$1,052.72
UnitedHealthcare
$1,073.60
Aetna
$1,282.97
Cigna
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CPT 25394
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, L.L.C.
$11,291.00Published rateAscension Saint Thomas Lebanon Surgery Center LLC, Lebanon Surgery Center
$5,433.00Published rateLakewood Surgery Center, LLC
Lakewood Surgery Center LLC
$3,685.00Published rateA Center For Foot And Ankle Surgery PA, The Center For Special Surgery Of Hawthorne
A Center For Foot And Ankle Su
$1,923.00Published rateThe Overland Park Ks Endoscopy Asc LLC, Endoscopic Imaging Center
The Overland Park Ks Endoscopy Asc LLC
$724.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 25394 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25394. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 25394-CPT | Osteoplasty, Carpal Bone, Shortening |
| 25430-CPT | Insrt Of Vasculr Pedicle Into Carpal Bone (Eg Hori Proc), Insertion Of Vascular Pedicle Into Carpal Bone (Eg Hori Procedure) |
| 25431-CPT | Repair Nonunion Carpal Bone, Repair Of Nonunion Of Carpal Bone Excluding Carpal Scaphoid Navicular Includes Obtaining Graft And Necessary Fixation Each Bone |
| 25440-CPT | Repair Nonu Scphd Carpl B1, Repair Of Nonunion Scaphoid Carpal (Navicular) Bone With Or Without Radial Styloidectomy (Includes Obtaining Graft And Necessary Fixation) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25394. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25394 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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Frequently Asked Questions
What APC is CPT 25394 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 25394 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 25394 in an ambulatory surgery center?
CMS lists CPT 25394 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 25394?
Hospital price transparency files list CPT 25394 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.