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See a sample rate comparisonCPT 25805 Fee Schedule
Medicare rates as of October 2026
CPT 25805 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Fuse Bones In Wrist, Surgery To Join Together Two Or More Bones Of The Wrist. The Procedure Is Done To Relieve Pain By Eliminating Motion Between The Bones.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 20705 |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $792.27 national non-facility rate (2026)View Medicare rates for 25805 |
| Medicaid Fee Schedule | $630.94 median of the 8 states in the free previewView Medicaid rates for 25805 |
National average reimbursement for CPT 25805 by major payers:
$1,147.46
BCBS / Anthem
$1,151.80
UnitedHealthcare
$1,162.27
Aetna
$1,397.31
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 25805.
CPT 25805
5 of 25 sample ratesHigher to lower in this preview
Castle Hills Surgicare, LLC
Castle Hills Surgicare LLC
$8,818.00Published rateSurgery Centre Of Sw Florida LLC, Fort Myers Surgery Center
$6,087.00Published rateJourney Lite Of Cincinnati, LLC
Journeylite Of Cincinnati, LLC
$3,487.00Published rateState Hill Surgicenter LLC
$1,562.00Published rateCentral Florida Eye Institute Pl
$812.07Published rate
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See a sample payer proposalCPT 25805 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25805. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 25800-CPT | Fuse Bones In Wrist, Surgery To Join Together Two Or More Bones Of The Wrist. The Procedure Is Done To Relieve Pain By Eliminating Motion Between The Bones. |
| 25805-CPT | Fuse Bones In Wrist, Surgery To Join Together Two Or More Bones Of The Wrist. The Procedure Is Done To Relieve Pain By Eliminating Motion Between The Bones. |
| 25810-CPT | Fuse Bones In Wrist, Surgery To Join Together Two Or More Bones Of The Wrist. The Procedure Is Done To Relieve Pain By Eliminating Motion Between The Bones. |
| 25830-CPT | Join Wrist Bones Together, Surgery To Join Together Bones Of Wrist Joint (Radius And Ulna). The Procedure Is Done To Relieve Pain By Eliminating Motion Between The Bones. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25805 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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Frequently Asked Questions
What APC is CPT 25805 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 25805 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 25805 in an ambulatory surgery center?
CMS lists CPT 25805 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 25805?
CMS add-on code edits list CPT 25805 as a primary code for these add-on codes: 20705.
Which revenue codes are billed with CPT 25805?
Hospital price transparency files list CPT 25805 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.