CPT 25605 Surgery

How Much Does Closed treatment of distal radial fracture Cost?

Closed treatment of distal radial fracture (CPT 25605) costs $243 at Medicare rates. Hospital outpatient rate: $1.

Cost Comparison by Payer

How much Closed treatment of distal radial fracture costs across different settings and payers

Medicare
Facility rate
$243
Hospital Outpatient
OPPS rate
$1
Surgery Center
ASC rate
$873
Medicare (Facility)
$243
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$295
Non-facility setting
Hospital Outpatient
$1
OPPS rate
Surgery Center (ASC)
$873
Ambulatory surgery center

Closed treatment of distal radial fracture Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $653 $968 — $1,489
AK — ALASKA* $330 $495 — $824
AL — ALABAMA $495 $740 — $1,139
AR — ARKANSAS $487 $729 — $1,122
AZ — ARIZONA $536 $805 — $1,238
AZ — Phoenix $249 $373 — $622
CA — BAKERSFIELD $567 $859 — $1,322
CA — CHICO $563 $854 — $1,314
CA — EL CENTRO $564 $855 — $1,315
CA — FRESNO $563 $854 — $1,314
CA — HANFORD-CORCORAN $563 $854 — $1,314
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $600 $912 — $1,403
CA — Los Angeles $266 $399 — $665
CA — MADERA $563 $854 — $1,314
CA — MERCED $563 $854 — $1,314
CA — MODESTO $563 $854 — $1,314
CA — NAPA $638 $977 — $1,502
CA — OXNARD-THOUSAND OAKS-VENTURA $595 $906 — $1,393
CA — REDDING $563 $854 — $1,314
CA — REST OF CALIFORNIA $563 $854 — $1,314
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $578 $873 — $1,344
CA — SACRAMENTO-ROSEVILLE-FOLSOM $587 $893 — $1,374
CA — SALINAS $585 $890 — $1,369
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $596 $908 — $1,398
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $670 $1,029 — $1,582

How to Reduce Your Cost for Closed treatment of distal radial fracture

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($295) differs from the facility rate ($243). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $237 to $687 depending on location. Commercial rates vary even more.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $873, compared to $1 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

5.04
Work RVU
1.85
Practice Expense RVU
0.62
Malpractice RVU

Payment = Total RVU () x CF ($33.40) = N/A

Frequently Asked Questions

How much does Closed treatment of distal radial fracture cost?

The Medicare facility rate for Closed treatment of distal radial fracture is $243. In a hospital outpatient setting, the rate is $1. At an ambulatory surgery center, the rate is $873. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Closed treatment of distal radial fracture cost without insurance?

Without insurance, the cost of Closed treatment of distal radial fracture can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Closed treatment of distal radial fracture?

Most commercial health insurance plans and Medicare cover Closed treatment of distal radial fracture when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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