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See a sample rate comparisonCPT 25405 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Poorly Healed Arm Bone, Surgery To Repair One Or Both Bones In The Lower Arm That Has Failed To Heal Completely Or That Healed In The Wrong Position After A Break.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25405 |
| Medicaid Fee Schedule | View Medicaid rates for 25405 |
National average reimbursement for CPT 25405 by major payers:
$1,451.93
$1,451.85
$1,460.02
$1,734.72
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CPT 25405
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Columbia Lp
$7,229.00Published rateProliance Surgeons, Inc., P.S., Proliance Center For Outpatient Spine And Joint Surgery
Proliance Surgeons, Inc., P.S.
$5,851.00Published rateSurgcenter Of Silver Spring, LLC
Surgcenter Of Silver Spring LLC
$4,134.00Published rateJacksonville Surgery Center, Ltd
Jacksonville Surgery Center Ltd
$1,682.00Published rateIsland Digestive Health Center, LLC
Island Digestive Health Center LLC
$979.00Published rate
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See a sample payer proposalCPT 25405 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25405 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 25405 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 |
|---|---|---|
| 25365-CPT | High | Surgery To Align Arm Bone, Surgery To Cut One Or More Bones In The Lower Arm (Radius Or Ulna). This Procedure Is Usually Done To Correct Positioning Of A Previously Broken Bone. |
| 25370-CPT | High | Revise Radius Or Ulna, Incisions Or Wedges Of One Or Both Forearm Bones (Ulna And Radius) With Insertion Of A Rod Inside The Bone |
| 25375-CPT | High | Multiple Osteotomies With Rea, Multiple Osteotomies With Realignment On Intramedullary Rod(Sofield Type Procedure) Radius And Ulna |
| 25405-CPT | High | Repair Poorly Healed Arm Bone, Surgery To Repair One Or Both Bones In The Lower Arm That Has Failed To Heal Completely Or That Healed In The Wrong Position After A Break. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25405 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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