Shortening Of One Of The Forearm Bones
What Medicare pays for 25390, what providers bill, and how the price varies across 13 states, drawn from CMS 2023 claims data.
25390 · the short answer
For shortening of one of the forearm bones, Medicare pays about $1,096.19 while providers bill $5,860.45 on average, a 5.3× markup, a below-median markup. State-level Medicare rates range 137% from lowest to highest.
- Medicare pays
- $1,096.19
- Providers bill
- $5,860.45
- Markup
- 5.3×
- Markup percentile
- 47th
Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Musculoskeletal Surgery procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Where this markup sits nationally
Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate
5 more affordable than 47% of 8,901 procedures
Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Physician & Other Practitioners · 2023
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| California | $1,403.22 | $8,529.69 |
| New York | $1,310.97 | $7,990.63 |
| Arizona | $1,304.47 | $6,672.78 |
| Washington | $1,263.34 | $5,095.23 |
| Arkansas | $1,251.19 | $10,518.36 |
| Michigan | $1,215.36 | $5,652.83 |
| North Carolina | $1,207.40 | $5,203.73 |
| Colorado | $1,205.02 | $6,350.40 |
| Texas | $1,115.19 | $4,443.07 |
| Pennsylvania | $1,045.75 | $4,783.55 |
| Florida | $926.97 | $4,529.89 |
| Massachusetts | $799.23 | $4,465.97 |
| South Carolina | $592.72 | $3,534.39 |
What the Data Says About Shortening Of One Of The Forearm Bones
Across 13 states with reporting providers, CPT code 25390 (Shortening Of One Of The Forearm Bones) shows a national average Medicare payment of $1,096.19 against an average billed charge of $5,860.45. That gap, a 5.3x markup, or 435% above the Medicare allowed amount, is narrower than most procedures in our dataset, suggesting providers price this code closer to what payers actually reimburse.
Musculoskeletal Surgery procedures like this one saw 592 services billed to Medicare in 2023 by 471 distinct providers, serving 352 unique beneficiaries. State-level variation is significant: South Carolina reports the lowest average payment at $592.72, while California reports the highest at $1,403.22. A 137% spread this wide is typically a GPCI story: practice-expense and malpractice-premium components of the fee formula diverge sharply by locality even though the procedure code never changes.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Musculoskeletal Surgery category (2.24x), the estimated commercial insurance price lands near $3,093.22, with self-pay cash discounts commonly bringing the figure closer to $2,647.30. Within Musculoskeletal Surgery, Shortening Of One Of The Forearm Bones ranks #80 of 1411 tracked procedures by national average Medicare payment.
What to do with this
If you may have shortening of one of the forearm bones done, these steps turn the numbers above into a real-world cost estimate.
- Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
- Compare shortening of one of the forearm bones costs in your state, Medicare rates vary by locality. Browse states
- Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
- Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide
Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.
Frequently Asked Questions
How much does Shortening Of One Of The Forearm Bones cost?
Shortening Of One Of The Forearm Bones (CPT 25390) shows unusually wide state-to-state pricing: Medicare pays $1,096.19 on average nationally, but the $592.72-$1,403.22 range across states spans more than double from cheapest to priciest.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Shortening Of One Of The Forearm Bones cost with insurance?
With commercial insurance, shortening of one of the forearm bones costs an estimated $3,093.22 on average (range: $2,165.26-$4,330.51), a moderate premium over Medicare's $1,096.19. Without insurance, the estimated cash price is $2,647.30.
Which state has the lowest cost for Shortening Of One Of The Forearm Bones?
South Carolina has by far the lowest average Medicare payment for Shortening Of One Of The Forearm Bones at $592.72, while California pays more than double at $1,403.22 - a $810.50 gap.
How many providers perform Shortening Of One Of The Forearm Bones?
Shortening Of One Of The Forearm Bones is comparatively uncommon: only 471 providers nationally billed Medicare for it in 2023, serving 352 beneficiaries via 592 total services.
What is the billed-to-Medicare markup for Shortening Of One Of The Forearm Bones?
Providers bill 5.3x what Medicare pays for Shortening Of One Of The Forearm Bones - a below-median markup at 435% above the Medicare rate.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.