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CPT 25685 Fee Schedule

Last Verified: January 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 Trans-Scaphoperilunar
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 25685

National average reimbursement for CPT 25685 by major payers:

bcbs

$1,002.35

uhc

$991.08

aetna

$1,012.11

cigna

$1,238.03

Preview provider-level rates for...
For billing codeCPT 25685
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 25685

United
25685$1505.001326089715 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER860423068 - SOUTHWESTERN EYE CENTER, LTD.AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$1810.001174873780 - YORKVILLE ENDOSCOPY, LLC460857425 - (NY) YORKVILLE ENDOSCOPY LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$2795.001194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$960.001770645905 - SILVER SPRING MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND205988845 - (MD) SILVER SPRING MD ENDOSCOPY ASC LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$2307.001952749491 - HAYMARKET SURGERY CENTER, LLC462874962 - (VA) HAYMARKET SURGERY CENTERVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$750.001801094669 - CLEVELAND EYE AND LASER SURGERY CENTER LLC205487161 - (OH) CLEVELAND EYE & LASER SURGERY CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$2206.001720325160 - SURGCENTER OF DEER VALLEY, LLC461512703 - (AZ) SURGCENTER OF DEER VALLEY LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$811.001922193515 - MAHONING VALLEY AMBULATORY SURGERY CENTER INC233056394 - (PA) MAHONING VALLEY AMBULATORY SURGERY CENTER INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$1059.001700205150 - OHI WEST, INC, BAYFRONT HEALTH AMBULATORY SURGERY CENTER845074208 - (FL) OHI WEST INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$587.001295847317 - DIGESTIVE HEALTH & ENDOSCOPY CENTER LLC204370189OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$1148.001457350449 - BAPTIST AND PHYSICIANS OUTPATIENT SURGERY CENTER OF NORTH MS, LP, OXFORD SURGERY CENTER640925692 - (MS) BAPTIST AND PHYSICIANS OUTPATIENT SURGERY CENTER OF NORTH MS LPMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$4544.001316487093 - NORTH SHORE SURGICAL SUITES, LLC, NORTH SHORE SURGICAL SUITES814641285 - (WI) NORTH SHORE SURGICAL SUITES, LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$1550.001669405684 - PACIFICOAST AMBULATORY SURGICENTER, LLC., PACIFIC COAST AMBULATORY SURGICENTER474003673 - (CA) PACIFICOAST AMBULATORY SURGICENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$2388.001841626090 - COLUMBUS ENDOSCOPY CENTER LLC463368948GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
25685$962.001902849227 - EYE SURGERY CENTER, LLC371221499 - (IL) EYECARE MANAGEMENT, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 25685 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 25685 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 25685 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.

CodeComplexityDescription
25675-CPTModerateTx Closed Distal Radioulnar Dislocation
25676-CPTModerateOpen Dist Radioulnar Dis Acute/Chrn
25680-CPTModerateTx Cl Trans-Scaphoperilunar Type Fx Disl
25685-CPTHighOpen Trans-Scaphoperilunar

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 25685 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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