CPT 25607 Surgery - Musculoskeletal
Optx dst rd xartc fx/epi sep Cost
Body System: Musculoskeletal
Medicare Facility Rate
$697
CMS PFS CY2026
Medicare Non-Facility Rate
$697
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
9.32
Work RVU
9.68
Facility PE RVU
1.88
Malpractice RVU
20.88
Total RVU
Frequently Asked Questions
How much does Optx dst rd xartc fx/epi sep cost?
The Medicare facility rate is $697. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Optx dst rd xartc fx/epi sep cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $697.