CPT 25609 Surgery - Musculoskeletal
Optx dst rd xart fx/ep sep3+ Cost
Body System: Musculoskeletal
Medicare Facility Rate
$968
CMS PFS CY2026
Medicare Non-Facility Rate
$968
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
14.02
Work RVU
12.22
Facility PE RVU
2.75
Malpractice RVU
28.99
Total RVU
Frequently Asked Questions
How much does Optx dst rd xart fx/ep sep3+ cost?
The Medicare facility rate is $968. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Optx dst rd xart fx/ep sep3+ 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 $968.