CPT 25607 Surgery - Musculoskeletal

How Much Does Optx Dst Rd Xartc Fracture/epi Sep Cost?

Also known as: Optx dst rd xartc fx/epi sep (CPT 25607)

Surgical treatment of a distal radius (wrist) fracture with internal fixation (plate and screws).

The total estimated cost of Optx Dst Rd Xartc Fracture/epi Sep (CPT 25607) is $2,343 to $4,393, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $697.

Total Estimated Cost of Care

$2,343 — $4,393

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$697
Hospital Facility Fee
$2,092
Anesthesia (est.)
$139
Important: The physician fee of $697 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$697
Physician component only — CMS PFS 2026

Patient Guide: Optx Dst Rd Xartc Fracture/epi Sep

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon makes an incision on the wrist, realigns the broken bone, and secures it with a metal plate and screws. A splint is applied after.

How Long Does It Take?

1-2 hours

Common Reasons Doctors Order This

Displaced wrist fracture, unstable wrist fracture, comminuted (shattered) wrist fracture, fracture extending into the joint

How to Prepare

Fast before surgery. Remove all jewelry from the hand and wrist. Expect a splint for 2 weeks then a removable brace. Hand therapy helps restore full motion.

Procedures Commonly Done Together

These procedures are frequently performed alongside Optx dst rd xartc fx/epi sep

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How to Reduce Your Cost for Optx dst rd xartc fx/epi sep

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.

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.

9.32
Work RVU
9.68
Practice Expense RVU
1.88
Malpractice RVU
20.88
Total RVU

Payment = Total RVU (20.88) x CF ($33.40) = $697

Frequently Asked Questions

How much does Optx dst rd xartc fx/epi sep cost?

The Medicare facility rate for Optx dst rd xartc fx/epi sep is $697. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Optx dst rd xartc fx/epi sep cost without insurance?

Without insurance, the cost of Optx dst rd xartc fx/epi sep 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 Optx dst rd xartc fx/epi sep?

Most commercial health insurance plans and Medicare cover Optx dst rd xartc fx/epi sep 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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