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See a sample rate comparisonCPT 25430 Fee Schedule
Medicare rates as of October 2026
CPT 25430 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Insrt Of Vasculr Pedicle Into Carpal Bone (Eg Hori Proc), Insertion Of Vascular Pedicle Into Carpal Bone (Eg Hori Procedure)
| 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 | RTRight side of body LTLeft 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 | $695.41 national non-facility rate (2026)View Medicare rates for 25430 |
| Medicaid Fee Schedule | $554.925 median of the 8 states in the free previewView Medicaid rates for 25430 |
National average reimbursement for CPT 25430 by major payers:
$974.32
BCBS / Anthem
$969.37
UnitedHealthcare
$1,001.42
Aetna
$1,190.85
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 25430.
CPT 25430
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Brazoria, LLC
Memorial Hermann Surgery Center Brazoria LLC
$7,770.00Published rateMay Street Surgi Center, LLC, May Street Surgi Center
May Street Surgi Center, LLC
$4,839.00Published rateRed Rocks Surgery Centers, LLC
Red Rocks Surgery Centers LLC
$2,781.00Published ratePiedmont Day Surgery Center Inc
$1,624.00Published rateHowerton Surgical Center, LLC
Howerton Surgical Center LLC
$550.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 25430 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25430. 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 25430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25430 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 25430 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 25430 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 25430 in an ambulatory surgery center?
CMS lists CPT 25430 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 25430?
Hospital price transparency files list CPT 25430 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.