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See a sample rate comparisonCPT 25609 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.
Open Treatment Of Distal Radia, Open Treatment Of Distal Radial Intra-Articular Fracture Or Epiphyseal Separation With Internal Fixation Of 3 Or More Fragments
| 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 25609 |
| Medicaid Fee Schedule | View Medicaid rates for 25609 |
National average reimbursement for CPT 25609 by major payers:
$1,370.17
$1,397.29
$1,486.24
$1,728.40
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CPT 25609
5 of 25 sample ratesHigher to lower in this preview
Columbia Hospital At Medical City Dallas Subsidiary Lp, Medical City Dallas
$21,000.00Published ratePhysicians Surgery Center Of Chattanooga, LLC, Physicians Surgery Center Of Chattanooga
Physicians Surgery Center Of Chattanooga LLC
$6,588.00Published rateAnnapolis Endoscopy Center LLC
$3,826.00Published rateMoses Cone Medical Services Inc., Lebauer Endoscopy Center
Moses Cone Medical Services Inc
$2,715.00Published rateCourtney Merkel
Deaconess Hospital Inc
$840.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 25609 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25609 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 25609 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 |
|---|---|---|
| 25600-CPT | Moderate | Treat Fracture Radius Ulna, Closed Treatment Of Distal Radial Fracture Eg Colles Or Smith Type Or Epiphyseal Separation Includes Closed Treatment Of Fracture Of Ulnar Styloid When Performed Without Manipulation |
| 25605-CPT | Moderate | Treat Fracture Radius Ulna, Closed Treatment Of Distal Radial Fracture Eg Colles Or Smith Type Or Epiphyseal Separation Includes Closed Treatment Of Fracture Of Ulnar Styloid When Performed With Manipulation |
| 25606-CPT | Moderate | Stabilize A Broken Wrist, Immobilization Of A Broken Wrist Using Wire Inserted Through The Skin To Hold The Bone In Place. A Cast Is Applied. |
| 25609-CPT | High | Open Treatment Of Distal Radia, Open Treatment Of Distal Radial Intra-Articular Fracture Or Epiphyseal Separation With Internal Fixation Of 3 Or More Fragments |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25609 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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