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See a sample rate comparisonCPT 25445 Fee Schedule
Medicare rates as of October 2026
CPT 25445 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Arthropl.W/Prosth Replac;Trapezium
| 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 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $664.01 national non-facility rate (2026)View Medicare rates for 25445 |
| Medicaid Fee Schedule | $531.315 median of the 8 states in the free previewView Medicaid rates for 25445 |
National average reimbursement for CPT 25445 by major payers:
$1,023.63
BCBS / Anthem
$976.03
UnitedHealthcare
$1,008.40
Aetna
$1,189.55
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 25445.
CPT 25445
5 of 25 sample ratesHigher to lower in this preview
Physicians West Surgicenter, LLC
$10,749.00Published rateOrchard Creek Surgery Center, Orchard Creek Surgery Center
Orchard Creek Surgery Center
$4,091.00Published rateSouthtowns Surgery Center LLC
$2,264.00Published rateOrland Park Surgical Center LLC
Orland Park Surgical Center, LLC
$1,411.00Published ratePlymouth Laser Center, P.C., Plymouth Laser & Surgical Center
Plymouth Laser Center PC
$530.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 25445 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25445. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 25443-CPT | Arthroplst W/ Prosthet Replac; Scaphoid Carpal (Navicular), Arthroplasty With Prosthetic Replacement; Scaphoid Carpal (Navicular) |
| 25444-CPT | Wrist Joint Replacement, Surgery To Replace Worn Out Ends Of Wrist Joint With An Artificial Part (Prosthesis). |
| 25445-CPT | Arthropl.W/Prosth Replac;Trapezium |
| 25446-CPT | Arthroplst W/ Prosthet Replac; Distal Radius & Partial Or, Arthroplasty With Prosthetic Replacement; Distal Radius And Partial Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25445. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25445 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 25445 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 25445 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 25445 in an ambulatory surgery center?
CMS lists CPT 25445 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 25445?
Hospital price transparency files list CPT 25445 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.