CPT code 25394: Carpal osteotomy, shortening procedure2026 Medicare rate & RVUs in Missouri
Reports an operation that shortens a carpal bone, such as the lunate, to address selected wrist disorders involving carpal bone mechanics.
CMS doesn’t publish an office rate for 25394 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 25394 covers
This service involves surgically removing or reshaping bone to shorten a carpal bone, such as the lunate. A hand or orthopedic surgeon may perform it for selected wrist conditions in which changing carpal bone length is part of the treatment plan; lunate disorders such as Kienböck disease are one clinical context. The operative report should identify the bone and describe the shortening procedure performed.
Report this code for shortening a carpal bone, not for an osteotomy that shortens the radius or ulna. Documentation should support the affected bone, side, indication, and procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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.
Where 25394 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $715.04 |
| Metropolitan St. Louis, MO | Unavailable | $720.90 |
| Rest of Missouri | Unavailable | $691.17 |
How the 25394 rate is calculated
Each of 25394’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.
How the rate is built · 25394
RVUs × geographic indexes × conversion factor
Work10.58
10.58 RVUs× 1.000 GPCI
Practice expense9.19
9.19 RVUs× 1.000 GPCI
Malpractice2.25
2.25 RVUs× 1.000 GPCI
Adjusted RVUs
22.0200
Conversion factor
$33.4009
Medicare rate
$735.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25394
25394 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25394
Carpal osteotomy, shortening procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25394
Carpal osteotomy, shortening procedure
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25394 without 50 · national facility
$735.49
Carpal osteotomy, shortening procedure
25394-50 · Bilateral: 150%
$1,103.24
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
25394 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25390Bone shorteningRadius or ulna
- Choose 25390 when the operation shortens the radius or ulna. This code is for shortening a carpal bone.
- 25392Forearm osteotomyBoth bones shortened
- 25392 covers shortening both forearm bones; this code applies when the shortened bone is carpal.
- 25391Bone lengtheningOne forearm bone
- 25391 is for lengthening a radius or ulna. This code describes shortening a carpal bone.
25394 billing questions
How does this differ from a forearm-bone shortening code?
This code is for shortening a carpal bone in the wrist. Use the radius or ulna codes when the osteotomy shortens one or both forearm bones.
What should the operative report identify?
Document the carpal bone treated, the side, the clinical indication, and the shortening procedure performed.
Can modifier 50 be used for bilateral work?
Yes. CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and additional procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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