CPT 25605: Closed Reduction of Displaced Distal Radius Fracture
Medicare pays $652 and commercial payers pay $932 on average nationally for this procedure.
CPT code 25605 describes a closed reduction of a displaced distal radial (wrist-end of the radius) fracture, where the clinician manipulates bone fragments back into alignment without making an incision; this is a closed fracture treatment procedure typically performed in an ambulatory surgical center, emergency department, or outpatient clinic and is part of orthopaedic trauma care for distal radius fractures.
For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).
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National Reimbursement Benchmarks
Medicare’s mean rate of $652.20 sits below the BUCA average commercial mean of $931.70, indicating that commercial contracts (as represented by BUCA) pay materially more on average for CPT 25605 than the Medicare program. The gap of $279.50 highlights a notable differential between federal reimbursement levels and a commercial benchmark, with BUCA positioned well above Medicare in absolute mean dollars.
Dispersion measured by the interquartile spread (P75 minus P25) varies across payers: Blue Cross Blue Shield has the widest IQR at $592.50 ($1,263.60 - $671.10), followed closely by UnitedHealth Group at $549.70 and Cigna at $493.60. Aetna shows the tightest IQR at $142.00, indicating relatively concentrated commercial rates around its median, while BUCA’s IQR is $556.50 and Medicare’s IQR is narrow at $70.00.