How Much Does Optx Carpl Scphd Fracture Internal Fixation Cost?
Also known as: Optx carpl scphd fx int fixj (CPT 25628)
Surgical treatment of a scaphoid (wrist bone) fracture with internal fixation.
The total estimated cost of Optx Carpl Scphd Fracture Internal Fixation (CPT 25628) is $2,248 to $4,215, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $669.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Optx Carpl Scphd Fracture Internal Fixation
What you need to know before your appointment
What to Expect
Under anesthesia, the surgeon inserts a screw through the broken scaphoid bone to hold it together while it heals. A cast or splint is applied.
How Long Does It Take?
1-1.5 hours
Common Reasons Doctors Order This
Displaced scaphoid fracture, scaphoid fracture not healing (nonunion), scaphoid fracture in active patient requiring faster return to activity
How to Prepare
Fast before surgery. Scaphoid fractures take 8-12 weeks to heal due to limited blood supply. No heavy gripping for 6-8 weeks.
Procedures Commonly Done Together
These procedures are frequently performed alongside Optx carpl scphd fx int fixj
How to Reduce Your Cost for Optx carpl scphd fx int fixj
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (20.03) x CF ($33.40) = $669
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Optx carpl scphd fx int fixj cost?
The Medicare facility rate for Optx carpl scphd fx int fixj is $669. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Optx carpl scphd fx int fixj cost without insurance?
Without insurance, the cost of Optx carpl scphd fx int fixj can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Optx carpl scphd fx int fixj?
Most commercial health insurance plans and Medicare cover Optx carpl scphd fx int fixj when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.