CPT code 25400: Forearm bone repair, one bone, without graft2026 Medicare rate & RVUs in South Carolina

Reports operative repair of a radius or ulna fracture nonunion or malunion when one forearm bone is treated without a graft.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In South Carolina, Medicare pays $703.72 for 25400 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$703.72Hospital or facility

Check a contract rate as a % of Medicare · 25400 nationwide

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

We’ll open 25400 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 25400 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 25400 covers

This operation treats a radius or ulna fracture that has failed to unite or has healed in a position requiring correction. An orthopedic surgeon works on the affected forearm bone to address the nonunion or malalignment and restore stability. The service is typically performed in an operating room, including a hospital outpatient department or inpatient setting, rather than as routine fracture follow-up.

Report this code when the repair involves one bone and is performed without a graft; use the applicable family code when both bones or grafting are involved. The operative report should identify the bone, the nonunion or malunion being treated, and the repair performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 South Carolina compares for 25400

Across 109 of 109 payment localities, the facility rate for 25400 runs from $660.21 in Arkansas to $907.81 in Alaska. South Carolina pays $703.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

25400 in South Carolina vs other payment areas
  1. South Carolina · this page$703.72
  2. Los Angeles, CA · California$782.44+$78.72
  3. Washington, DC area · District of Columbia$818.12+$114.40
  4. Miami, FL · Florida$859.67+$155.95
  5. Chicago, IL · Illinois$834.65+$130.93
  6. Manhattan, NY · New York$851.16+$147.44
  7. Alaska · Alaska$907.81+$204.09

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

25400 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$668.65
ArkansasArkansas—$660.21
ArizonaArizona—$717.54
Bakersfield, CACalifornia—$744.50
Chico, CACalifornia—$738.50
El Centro, CACalifornia—$738.86
Fresno, CACalifornia—$738.50
Hanford, CACalifornia—$738.50

25400 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
25400 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 25400 in every payment locality

How the 25400 rate is calculated

Each of 25400’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 · 25400

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.00

11.00 RVUs× 1.000 GPCI

Practice expense8.91

8.91 RVUs× 1.000 GPCI

Malpractice2.16

2.16 RVUs× 1.000 GPCI

Adjusted RVUs

22.0700

Conversion factor

$33.4009

Medicare rate

$737.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,449

Code
25400
Physician work
11.00
Practice expense
8.91
Malpractice
2.16

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Facility calculation for 25400 in South Carolina
ComponentRVULocality factorAdjusted
Physician work11.00× 1.00011.0000
Practice expense8.91× 0.9248.2328
Malpractice2.16× 0.8501.8360
Total RVUs21.0688
Conversion factor× 33.4009

Facility rate, South Carolina$703.72

Facility: (11 × 1 + 8.91 × 0.924 + 2.16 × 0.85) × $33.4009 = $703.72

Open 25400 in the RVU calculator

Payment rules and modifiers for 25400

25400 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25400

Forearm bone repair, one bone, without graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25400

Forearm bone repair, one bone, without graft

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25400 without 50 · national facility

$737.16

Forearm bone repair, one bone, without graft

25400-50 · Bilateral: 150%

$1,105.74

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).

When to use modifier 50

How 25400 has changed in South Carolina

25400 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$703.72RVU26D
2026-07-01Not available in this setting$703.72RVU26C
2026-04-01Not available in this setting$703.72RVU26B
2026-01-01Not available in this setting$703.72RVU26A
2025-10-01Not available in this setting$750.71RVU25D
2025-07-01Not available in this setting$750.71RVU25C
2025-04-01Not available in this setting$750.71RVU25B
2025-01-01Not available in this setting$750.71RVU25A
2024-10-01Not available in this setting$765.73RVU24D
2024-07-01Not available in this setting$765.73RVU24C
2024-04-01Not available in this setting$765.73RVU24B
2024-03-09Not available in this setting$765.73RVU24AR
2024-01-01Not available in this setting$753.24RVU24A
2023-10-01Not available in this setting$768.72RVU23D
2023-07-01Not available in this setting$768.72RVU23C
2023-04-01Not available in this setting$768.72RVU23B
2023-01-01Not available in this setting$768.72RVU23A
2022-10-01Not available in this setting$767.86RVU22D
2022-07-01Not available in this setting$767.86RVU22C
2022-04-01Not available in this setting$767.86RVU22B
2022-01-01Not available in this setting$767.86RVU22A
2021-10-01Not available in this setting$770.32RVU21D
2021-07-01Not available in this setting$770.32RVU21C
2021-04-01Not available in this setting$770.32RVU21B
2021-01-01Not available in this setting$770.32RVU21A
2020-10-01Not available in this setting$775.05RVU20D
2020-07-01Not available in this setting$775.05RVU20C
2020-04-01Not available in this setting$775.05RVU20B
2020-01-01Not available in this setting$775.05RVU20A
2019-10-01Not available in this setting$768.50RVU19D
2019-07-01Not available in this setting$768.50RVU19C
2019-04-01Not available in this setting$768.50RVU19B
2019-01-01Not available in this setting$768.50RVU19A
2018-10-01Not available in this setting$768.12RVU18D
2018-07-01Not available in this setting$768.12RVU18C
2018-04-01Not available in this setting$768.12RVU18B
2018-01-01Not available in this setting$768.12RVU18AR1
2017-10-01Not available in this setting$769.64RVU17D
2017-07-01Not available in this setting$769.64RVU17C
2017-04-01Not available in this setting$769.64RVU17B
2017-01-01Not available in this setting$769.64RVU17A
2016-10-01Not available in this setting$773.44RVU16D
2016-07-01Not available in this setting$773.44RVU16C
2016-04-01Not available in this setting$773.44RVU16B
2016-01-01Not available in this setting$773.44RVU16A
2015-10-01Not available in this setting$776.04RVU15D
2015-07-01Not available in this setting$776.04RVU15C
2015-04-01Not available in this setting$772.18RVU15B
2015-01-01Not available in this setting$772.18RVU15A
2014-10-01Not available in this setting$759.90RVU14D
2014-07-01Not available in this setting$759.90RVU14C
2014-04-01Not available in this setting$759.90RVU14B
2014-01-01Not available in this setting$759.90RVU14A
2013-10-01Not available in this setting$742.04RVU13D
2013-07-01Not available in this setting$742.04RVU13C
2013-04-01Not available in this setting$742.04RVU13B
2013-01-01Not available in this setting$742.04RVU13AR

Price 25400 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

25400 billing questions

When is 25400 appropriate instead of 25405?

Use 25400 for a one-bone radius or ulna repair without a graft. The grafted one-bone repair is represented by 25405.

Can 25400 be reported for both the radius and ulna?

When both forearm bones are repaired, the family includes codes for repair of the radius and ulna together. Do not use 25400 twice to represent that service.

What documentation supports 25400?

Document which bone is repaired, the nonunion or malunion being treated, and the operative work performed. The record should also support that the repair is without a graft.

How does the bilateral payment rule affect reporting?

For bilateral performance, report modifier 50; CMS lists payment at 150%. The operative documentation should support repair on both sides.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%.

Is an assistant or co-surgeon reportable for this operation?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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

Show the CMS file lines behind this rate
RVUs for 25400PPRRVU2026_Oct_nonQPP.csv, line 2,449 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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