Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 25431 Fee Schedule
Last Verified: September 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 Nonunion Carpal Bone, Repair Of Nonunion Of Carpal Bone Excluding Carpal Scaphoid Navicular Includes Obtaining Graft And Necessary Fixation Each Bone
| 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 25431 |
| Medicaid Fee Schedule | View Medicaid rates for 25431 |
National average reimbursement for CPT 25431 by major payers:
$1,077.97
$1,058.71
$1,082.26
$1,286.78
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 25431.
CPT 25431
5 of 25 sample ratesHigher to lower in this preview
Parkcreek Surgery Center Lllp
$6,506.00Published rateNewport Beach Surgery Center, LLC, Newport Beach Surgery Center
Newport Beach Surgery Center LLC
$4,080.00Published rateSansum Clinic, Sansum Clinic Asc
Sansum Clinic
$2,825.00Published rateJames Fouts
Deaconess Hospital Inc
$1,371.84Published rateInterventional Rehabilitation Center, LLC
Interventional Rehabilitation Center LLC
$626.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 25431 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25431 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 25431 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 |
|---|---|---|
| 25394-CPT | High | Osteoplasty, Carpal Bone, Shortening |
| 25430-CPT | Moderate | Insrt Of Vasculr Pedicle Into Carpal Bone (Eg Hori Proc), Insertion Of Vascular Pedicle Into Carpal Bone (Eg Hori Procedure) |
| 25431-CPT | High | Repair Nonunion Carpal Bone, Repair Of Nonunion Of Carpal Bone Excluding Carpal Scaphoid Navicular Includes Obtaining Graft And Necessary Fixation Each Bone |
| 25440-CPT | Moderate | 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 25431. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25431 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 25431) and we'll show you how you compare in 15 minutes or less.