CPT 25028 Surgery - Musculoskeletal

How Much Does I&d F/arm&/wrst Dp Absc/hmtm Cost?

Also known as: I&d f/arm&/wrst dp absc/hmtm (CPT 25028)

I&d F/arm&/wrst Dp Absc/hmtm (CPT 25028) costs $688 at Medicare rates. Hospital outpatient rate: $3.

Cost Comparison by Payer

How much I&d f/arm&/wrst dp absc/hmtm costs across different settings and payers

Medicare
Facility rate
$688
Hospital Outpatient
OPPS rate
$3
Surgery Center
ASC rate
$1
Medicare (Facility)
$688
CMS PFS 2026 national rate
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside I&d f/arm&/wrst dp absc/hmtm

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How to Reduce Your Cost for I&d f/arm&/wrst dp absc/hmtm

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

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $1, compared to $3 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.

5.26
Work RVU
14.27
Practice Expense RVU
1.07
Malpractice RVU
20.60
Total RVU

Payment = Total RVU (20.60) x CF ($33.40) = $688

Frequently Asked Questions

How much does I&d f/arm&/wrst dp absc/hmtm cost?

The Medicare facility rate for I&d f/arm&/wrst dp absc/hmtm is $688. In a hospital outpatient setting, the rate is $3. At an ambulatory surgery center, the rate is $1. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does I&d f/arm&/wrst dp absc/hmtm cost without insurance?

Without insurance, the cost of I&d f/arm&/wrst dp absc/hmtm 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 I&d f/arm&/wrst dp absc/hmtm?

Most commercial health insurance plans and Medicare cover I&d f/arm&/wrst dp absc/hmtm 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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