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See a sample rate comparisonCPT 25630 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25630 |
| Medicaid Fee Schedule | View Medicaid rates for 25630 |
National average reimbursement for CPT 25630 by major payers:
$408.99
$403.14
$430.87
$499.60
Compare published rates across providers.
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CPT 25630
5 of 25 sample ratesHigher to lower in this preview
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC, Iu Health Surgery Center Fort Wayne
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC
$4,613.00Published rateSuburban Endoscopy Center, LLC, Suburban Endoscopy Center
Suburban Endoscopy Center LLC
$703.00Published rateEhi Surgery Center Austin, LLC, Legent Outpatient Surgery - Austin
Ehi Surgery Center Austin LLC
$318.00Published ratePerimeter Surgical Center Inc
$121.00Published rateWest Shore Endoscopy Center LLC
$77.00Published rate
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See a sample payer proposalCPT 25630 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25630 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 25630 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 25630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25630 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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