How much does Medicare pay for CPT 25210?

Medicare allowed an average of $449.80 per service and paid $357.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3085.97, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 25210?

Removal of wrist bone. It was billed 1,346 times to 1,290 Medicare beneficiaries by 75 providers in 2024.

Does 25210 pay differently in an office than a hospital?

Yes. The allowed amount averaged $237.05 in an office setting and $452.20 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 25210 most?

Hand Surgery, with 538 services from 32 clinicians. Next are Ambulatory Surgical Center, Orthopedic Surgery, Physician Assistant.

CPT 25210

Removal of wrist bone

$449.80Medicare-allowed amount per service, averaged across 1,346 services

Providers submitted

$3085.97

Asking price, not received

Medicare allowed

$449.80

The fee schedule figure

Medicare paid

$357.96

Balance is patient coinsurance

Providers submitted an average of $3085.97 for this code and Medicare allowed $449.80 — 6.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $357.96 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $237.05
Hospital / facility: $452.20

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 15 services were billed in an office setting and 1,331 in a facility.

Services: 1,346
Beneficiaries: 1,290
Providers billing it: 75
Total allowed: $605,431

What Medicare pays for CPT 25210

Across 1,346 services billed by 75 providers to 1,290 beneficiaries, Medicare allowed an average of $449.80 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 25210

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hand Surgery	538	513	$249.03	32
Ambulatory Surgical Center	460	438	$875.70	24
Orthopedic Surgery	270	263	$244.92	14
Physician Assistant	67	65	$32.90	4
Nurse Practitioner	11	11	$27.09	1

25210 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	146	$299.01	$252.64	9
Washington	139	$456.60	$358.04	7
Arizona	133	$300.88	$243.13	6
Arkansas	117	$497.78	$425.62	2
California	78	$497.44	$355.18	5
Virginia	73	$531.91	$455.27	3
South Carolina	73	$236.10	$199.33	4
Texas	69	$344.34	$294.26	4
Pennsylvania	65	$446.24	$367.30	5
Colorado	58	$851.47	$667.00	3
North Carolina	57	$1000.62	$828.72	2
Maryland	53	$539.98	$426.10	4
Ohio	35	$535.93	$458.44	2
Kentucky	29	$394.67	$435.78	2
Georgia	26	$134.86	$129.06	2
Minnesota	23	$556.94	$465.05	2
Connecticut	17	$772.31	$584.29	1
North Dakota	17	$239.12	$197.36	1
Massachusetts	15	$266.72	$197.55	1
Delaware	15	$240.81	$196.70	1
Guam	15	$283.44	$210.30	1
Alabama	14	$209.74	$200.16	1
New Hampshire	12	$265.39	$196.48	1
Nevada	12	$783.81	$644.97	1
Maine	11	$255.26	$197.26	1
Illinois	11	$1368.72	$1163.67	1
South Dakota	11	$236.91	$196.38	1
New York	11	$295.87	$196.38	1
Tennessee	11	$231.84	$219.06	1

Related codes

25290Incision of tendon of forearm and/or wrist$384.26

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.