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See a sample rate comparisonCPT 25628 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery To Repair Broken Wrist, Surgery To Repair A Broken Bone In The Wrist. Pins Wires Or Screws May Be Used To Hold The Bones In Place.
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25628 |
| Medicaid Fee Schedule | View Medicaid rates for 25628 |
National average reimbursement for CPT 25628 by major payers:
$940.57
$963.49
$1,022.38
$1,179.65
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CPT 25628
5 of 25 sample ratesHigher to lower in this preview
Port Warwick Surgery Center, LLC
Port Warwick Surgery Center LLC
$11,344.00Published rateWarner Park Surgery Center LLC, Center For Advanced Surgery
Warner Park Surgery Center LLC
$6,492.00Published rateNorthwest Community Day Surgery Center II LLC
$3,991.00Published rateCardiovascular Asc LLC
$3,134.00Published rateSurgical Centers Of Michigan, LLC.
Surgical Centers Of Michigan LLC
$984.00Published rate
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See a sample payer proposalCPT 25628 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25628 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 25628 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 |
|---|---|---|
| 25624-CPT | Moderate | Closed Treatment Of Carpal Sca, Closed Treatment Of Carpal Scaphoid (Navicular) Fracturewith Manipulation Closed Treatment Of Carpal Scaphoid (Navicular) Fracture |
| 25628-CPT | Moderate | Surgery To Repair Broken Wrist, Surgery To Repair A Broken Bone In The Wrist. Pins Wires Or Screws May Be Used To Hold The Bones In Place. |
| 25630-CPT | Moderate | Closed Treatment Of Carpal Bon, Closed Treatment Of Carpal Bone Fracture (Excluding Carpalscaphoid (Navicular)) Without Manipulation Each Bone Closed Treatment Of Carpal Bone Fracture (Excluding Carpal |
| 25635-CPT | Moderate | Closed Treatment Of Carpal Bon, Closed Treatment Of Carpal Bone Fracture (Excluding Carpalscaphoid (Navicular)) With Manipulation Each Bone Closed Treatment Of Carpal Bone Fracture (Excluding Carpal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25628. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25628 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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