CPT code 25391: Bone lengthening, one forearm bone2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $921.61 for 25391 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 25391 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 25391 covers

The surgeon makes a corrective cut in one forearm bone and lengthens it to address shortening or a resulting alignment problem. Orthopedic and hand surgeons may perform this operation for a growth-related difference, congenital shortening, or a post-traumatic deformity. It is generally performed in an operating room, often in a hospital or ambulatory surgery setting; the operative report should identify the bone treated and the lengthening performed.

Report 25391 when the procedure lengthens either the radius or the ulna, rather than both bones. Documentation should support the indication, the specific bone, and the operative work; lengthening both bones is represented by a different code. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral payment is 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 25391

Across 109 of 109 payment localities, the facility rate for 25391 runs from $821.02 in Arkansas to $1,130.20 in Alaska. Puerto Rico pays $921.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

25391 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 25391 in every payment locality

How the 25391 rate is calculated

Each of 25391’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 25391

25391 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 25391

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 25391 has changed in Puerto Rico

Price 25391 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates