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See a sample rate comparisonCPT 25685 Fee Schedule
Last Verified: October 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 Trans-Scapho, Open Treatment Of Trans-Scaphoperilunar Type Of Fracturedislocation Open Treatment Of Trans-Scaphoperilunar Type Of Fracture
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 25685 |
| Medicaid Fee Schedule | View Medicaid rates for 25685 |
National average reimbursement for CPT 25685 by major payers:
$1,002.35
$991.08
$1,012.11
$1,207.39
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CPT 25685
5 of 25 sample ratesHigher to lower in this preview
North Shore Surgical Suites, LLC, North Shore Surgical Suites
North Shore Surgical Suites, LLC
$4,544.00Published rateSurgcenter Of Deer Valley, LLC
Surgcenter Of Deer Valley LLC
$2,206.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Center
Southwestern Eye Center, Ltd.
$1,505.00Published rateOhi West, Inc, Bayfront Health Ambulatory Surgery Center
Ohi West Inc
$1,059.00Published rateDigestive Health & Endoscopy Center LLC
$587.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 25680-CPT | Moderate | Treat Dislocated Broken Wrist, Treatment Of Broken And Dislocated Wrist Using Traction And Manual Movement Of Bone Into Proper Position. An Immobilizer Is Placed On The Arm And Wrist. |
| 25685-CPT | High | Open Treatment Of Trans-Scapho, Open Treatment Of Trans-Scaphoperilunar Type Of Fracturedislocation Open Treatment Of Trans-Scaphoperilunar Type Of Fracture |
| 25690-CPT | Moderate | Realign And Secure Dislocation, Treatment Of Dislocated Wrist By Manually Moving The Bone Into Proper Position. An Immobilizer Is Applied To The Arm And Wrist. |
| 25695-CPT | Moderate | Open Tx Of Lunate Dislocation |
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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