25609

Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device

Medicare pricing data for 9,059 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $634 in South Dakota to $2,127 in California. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device (HCPCS code 25609) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,543, but hospitals typically charge $6,456 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$308.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,543, your out-of-pocket cost would be approximately $308.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,543
Average Hospital Charge
$6,456
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$6,455.54
Medicare Allowed$1,542.77
Medicare Payment$1,227.14

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $1,227 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$2,127$8,5907172,935+37.8%
Hawaii$2,014$5,0892452+30.5%
Maryland$2,007$8,950175688+30.1%
Connecticut$1,929$8,298113319+25.0%
Alaska$1,887$9,73643156+22.3%
Mississippi$1,814$7,79884326+17.6%
Delaware$1,765$6,15338164+14.4%
Nevada$1,759$7,32862194+14.0%
Georgia$1,736$7,049264750+12.5%
New York$1,670$9,2334021,408+8.2%
Virginia$1,662$5,590220873+7.8%
Arizona$1,644$6,219217866+6.6%
New Jersey$1,637$10,699255676+6.1%
Iowa$1,624$6,08087266+5.3%
Oregon$1,610$4,903115328+4.4%
Pennsylvania$1,604$7,4853671,228+4.0%
New Mexico$1,596$4,50242147+3.4%
Washington$1,585$4,715256740+2.7%
Florida$1,577$7,2707673,039+2.2%
Illinois$1,561$7,1253371,363+1.2%
Tennessee$1,541$5,579235726-0.1%
Minnesota$1,540$6,412180431-0.2%
Michigan$1,537$7,105221613-0.3%
Colorado$1,534$6,520194637-0.6%
North Carolina$1,521$5,0792941,079-1.4%
Rhode Island$1,511$5,80036125-2.0%
Indiana$1,493$7,588245665-3.2%
Utah$1,412$4,88188231-8.5%
District of Columbia$1,410$5,5941334-8.6%
South Carolina$1,354$4,315174634-12.2%
Wyoming$1,320$5,7434378-14.5%
New Hampshire$1,307$5,89346166-15.3%
Texas$1,306$5,4156391,819-15.3%
Ohio$1,276$3,814319907-17.3%
Massachusetts$1,236$5,123210706-19.9%
Louisiana$1,225$4,656137446-20.6%
Montana$1,212$3,52454141-21.4%
Idaho$1,184$3,88257161-23.3%
Arkansas$1,180$4,01575230-23.5%
Missouri$1,170$4,974173518-24.2%
Nebraska$1,151$4,22680356-25.4%
Puerto Rico$1,143$1,3902031-25.9%
Wisconsin$1,118$7,381179459-27.6%
Alabama$1,117$2,846156361-27.6%
Kentucky$1,107$4,026125366-28.3%
West Virginia$981$4,0263363-36.4%
Kansas$870$3,543126384-43.6%
Oklahoma$855$2,198111347-44.6%
North Dakota$851$3,38635107-44.8%
Maine$794$2,8823144-48.5%
Vermont$788$2,9861217-48.9%
South Dakota$634$2,29156181-58.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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