CPT code 25609: Distal radius fixation, intra-articular, three or more fragments2026 Medicare rate & RVUs in Montana
Report 25609 for open reduction and fixation of a distal radius fracture involving the joint surface with three or more fragments.
In Montana, Medicare pays $968.11 for 25609 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 25609 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 25609 covers
This service involves surgically exposing a distal radius fracture, restoring alignment of the joint surface, and stabilizing the fracture with fixation. It is typically performed by an orthopedic or hand surgeon for a complex, comminuted fracture that extends into the wrist joint. The procedure is commonly performed in a hospital operating room or ambulatory surgery center.
Choose this code when the fracture is intra-articular and has three or more fragments; the operative report should establish joint involvement, fragment count, open treatment, and fixation performed. Reduction and fixation are part of the service, not separate procedures. CMS assigns a 90-day global period that 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are 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 Montana compares for 25609
Across 109 of 109 payment localities, the facility rate for 25609 runs from $866.19 in Arkansas to $1,187.72 in Alaska. Montana pays $968.11. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$968.11
- Los Angeles, CA · California$1,031.32+$63.21
- Washington, DC area · District of Columbia$1,076.61+$108.50
- Miami, FL · Florida$1,125.47+$157.36
- Chicago, IL · Illinois$1,092.56+$124.45
- Manhattan, NY · New York$1,118.21+$150.10
- Alaska · Alaska$1,187.72+$219.61
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $877.41 |
| ArkansasArkansas | — | $866.19 |
| ArizonaArizona | — | $942.41 |
| Bakersfield, CACalifornia | — | $980.46 |
| Chico, CACalifornia | — | $972.82 |
| El Centro, CACalifornia | — | $973.28 |
| Fresno, CACalifornia | — | $972.82 |
| Hanford, CACalifornia | — | $972.82 |
| Madera, CACalifornia | — | $972.82 |
| Merced, CACalifornia | — | $972.82 |
| Modesto, CACalifornia | — | $972.82 |
| Napa, CACalifornia | — | $1,082.40 |
| Oxnard, CACalifornia | — | $1,021.06 |
| Redding, CACalifornia | — | $972.82 |
| Rest of CaliforniaCalifornia | — | $972.82 |
| Riverside, CACalifornia | — | $1,002.40 |
| Sacramento, CACalifornia | — | $1,009.06 |
| Salinas, CACalifornia | — | $1,005.09 |
| San Diego, CACalifornia | — | $1,020.27 |
| Marin County, CACalifornia | — | $1,130.43 |
| San Francisco, CACalifornia | — | $1,127.31 |
| San Benito County, CACalifornia | — | $1,157.59 |
| Santa Clara County, CACalifornia | — | $1,144.82 |
| San Luis Obispo, CACalifornia | — | $990.37 |
| Santa Cruz, CACalifornia | — | $1,023.26 |
| Santa Maria, CACalifornia | — | $1,006.54 |
| Santa Rosa, CACalifornia | — | $1,032.78 |
| Stockton, CACalifornia | — | $972.82 |
| Vallejo, CACalifornia | — | $1,077.90 |
| Visalia, CACalifornia | — | $972.82 |
| Yuba City, CACalifornia | — | $972.82 |
| ColoradoColorado | — | $979.92 |
| ConnecticutConnecticut | — | $1,028.37 |
| DelawareDelaware | — | $956.46 |
| Fort Lauderdale, FLFlorida | — | $1,047.81 |
| Rest of FloridaFlorida | — | $996.53 |
| Atlanta, GAGeorgia | — | $994.69 |
| Rest of GeorgiaGeorgia | — | $941.85 |
| Hawaii, Guam, HIHawaii | — | $985.54 |
| IowaIowa | — | $878.21 |
| IdahoIdaho | — | $887.23 |
| East St. Louis, ILIllinois | — | $1,028.78 |
| Rest of IllinoisIllinois | — | $984.50 |
| Suburban Chicago, ILIllinois | — | $1,053.50 |
| IndianaIndiana | — | $891.28 |
| KansasKansas | — | $883.55 |
| KentuckyKentucky | — | $915.18 |
| New Orleans, LALouisiana | — | $956.70 |
| Rest of LouisianaLouisiana | — | $917.50 |
| Metropolitan Boston, MAMassachusetts | — | $1,056.57 |
| Rest of MassachusettsMassachusetts | — | $978.77 |
| Baltimore area, MDMaryland | — | $1,027.35 |
| Rest of MarylandMaryland | — | $970.34 |
| Rest of MaineMaine | — | $900.92 |
| Southern Maine, MEMaine | — | $930.73 |
| Detroit, MIMichigan | — | $1,017.02 |
| Rest of MichiganMichigan | — | $944.63 |
| MinnesotaMinnesota | — | $915.46 |
| Metropolitan Kansas City, MOMissouri | — | $941.28 |
| Metropolitan St. Louis, MOMissouri | — | $948.88 |
| Rest of MissouriMissouri | — | $909.58 |
| MississippiMississippi | — | $887.58 |
| North CarolinaNorth Carolina | — | $907.79 |
| North DakotaNorth Dakota | — | $913.73 |
| NebraskaNebraska | — | $879.73 |
| New HampshireNew Hampshire | — | $973.55 |
| Northern New JerseyNew Jersey | — | $1,069.35 |
| Rest of New JerseyNew Jersey | — | $1,033.48 |
| New MexicoNew Mexico | — | $952.88 |
| NevadaNevada | — | $953.36 |
| NYC suburbs and Long Island, NYNew York | — | $1,154.12 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,047.43 |
| Queens, NYNew York | — | $1,113.15 |
| Rest of New YorkNew York | — | $920.60 |
| OhioOhio | — | $933.52 |
| OklahomaOklahoma | — | $904.14 |
| Portland, OROregon | — | $997.58 |
| Rest of OregonOregon | — | $939.38 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,011.18 |
| Rest of PennsylvaniaPennsylvania | — | $929.77 |
| Puerto RicoPuerto Rico | — | $971.40 |
| Rhode IslandRhode Island | — | $980.74 |
| South CarolinaSouth Carolina | — | $923.49 |
| South DakotaSouth Dakota | — | $907.30 |
| TennesseeTennessee | — | $888.62 |
| Austin, TXTexas | — | $982.43 |
| Beaumont, TXTexas | — | $925.04 |
| Brazoria, TXTexas | — | $948.16 |
| Dallas, TXTexas | — | $957.83 |
| Fort Worth, TXTexas | — | $954.94 |
| Galveston, TXTexas | — | $953.38 |
| Houston, TXTexas | — | $1,003.72 |
| Rest of TexasTexas | — | $938.57 |
| UtahUtah | — | $934.43 |
| VirginiaVirginia | — | $934.35 |
| Virgin Islands, VIUnited States Virgin Islands | — | $971.40 |
| VermontVermont | — | $918.84 |
| Rest of WashingtonWashington | — | $974.06 |
| King County, WAWashington | — | $1,067.55 |
| WisconsinWisconsin | — | $887.59 |
| West VirginiaWest Virginia | — | $954.41 |
| WyomingWyoming | — | $944.41 |
25609 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 25609 rate is calculated
Each of 25609’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 · 25609
RVUs × geographic indexes × conversion factor
Work14.02
14.02 RVUs× 1.000 GPCI
Practice expense12.22
12.22 RVUs× 1.000 GPCI
Malpractice2.75
2.75 RVUs× 1.000 GPCI
Adjusted RVUs
28.9900
Conversion factor
$33.4009
Medicare rate
$968.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,490
- Code
- 25609
- Physician work
- 14.02
- Practice expense
- 12.22
- Malpractice
- 2.75
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.02 | × 1.000 | 14.0200 |
| Practice expense | 12.22 | × 1.000 | 12.2200 |
| Malpractice | 2.75 | × 0.998 | 2.7445 |
| Total RVUs | 28.9845 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$968.11
Facility: (14.02 × 1 + 12.22 × 1 + 2.75 × 0.998) × $33.4009 = $968.11
Payment rules and modifiers for 25609
25609 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25609
Distal radius fixation, intra-articular, three or more fragments
| 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) | 0 | Not permitted. |
| 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 · 25609
Distal radius fixation, intra-articular, three or more fragments
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
25609 without 50 · national facility
$968.29
Distal radius fixation, intra-articular, three or more fragments
25609-50 · Bilateral: 150%
$1,452.44
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).
How 25609 has changed in Montana
25609 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $968.11 | RVU26D |
| 2026-07-01 | Not available in this setting | $968.11 | RVU26C |
| 2026-04-01 | Not available in this setting | $968.11 | RVU26B |
| 2026-01-01 | Not available in this setting | $968.11 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,042.18 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,042.18 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,042.18 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,042.18 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,061.17 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,061.17 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,061.17 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,061.17 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,043.85 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,070.83 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,070.83 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,070.83 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,070.83 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,078.19 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,078.19 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,078.19 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,078.19 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,078.84 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,078.84 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,078.84 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,078.84 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,121.58 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,121.58 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,121.58 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,121.58 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,149.65 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,149.65 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,149.65 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,149.65 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,145.91 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,145.91 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,145.91 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,145.91 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,121.41 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,121.41 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,121.41 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,121.41 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,098.17 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,098.17 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,098.17 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,098.17 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,102.93 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,102.93 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,097.45 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,097.45 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,082.71 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,082.71 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,082.71 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,082.71 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,065.16 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,065.16 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,065.16 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,065.16 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
25609 billing questions
How is 25609 different from 25608?
Both describe open treatment of an intra-articular distal radius fracture with fixation. Use 25609 when there are three or more fragments; 25608 is for two fragments.
When should 25607 be reported instead?
25607 is for open treatment of an extra-articular distal radius fracture. The fracture treated with 25609 must extend into the wrist joint and involve three or more fragments.
Can reduction or fixation be billed separately?
No. The open reduction and fixation are included in 25609; document the fracture pattern and operative work supporting the code.
What documentation supports 25609?
The operative report should identify intra-articular extension, establish that three or more fragments are involved, and describe the open treatment and fixation.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral procedures or other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%.
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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