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Billing code 25035: Bone incisionMedicare rate & RVUs

Opening the cortex of a forearm or wrist bone provides surgical access to infected bone, such as in osteomyelitis or a bone abscess.

CMS RVU26DEffective Oct 1, 2026109 payment localities105 Medicare services in 2024

Medicare pays $563.47 for 25035 nationally in a facility.

Medicare rate · 25035

Bone incision

Swap in your local Medicare rate.

Work RVUs
7.46
Total RVUs
16.87
Global days
090

National rate · 2026

$563.47

Facility setting, before claim adjustments.

See every locality for 25035 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 25035 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 25035 covers

This operation opens the outer layer of a forearm or wrist bone to reach an infected area, such as osteomyelitis or a bone abscess, for drainage or debridement. An orthopedic surgeon typically performs it in a hospital or ambulatory surgery setting. The target is bone, not an abscess limited to soft tissue, a bursa, or a wrist joint.

Report the code when the operative work includes an incision through the bone cortex; document the affected bone, side, indication, and the work performed. It 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.

Where 25035 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

25035 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$507.78
Alaska*Unavailable$681.19
ArizonaUnavailable$547.73
ArkansasUnavailable$500.89
AtlantaUnavailable$579.07
AustinUnavailable$573.07
BakersfieldUnavailable$572.52
Baltimore/Surr. CntysUnavailable$599.11
BeaumontUnavailable$536.20
BrazoriaUnavailable$551.43

25035 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
25035 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

How the 25035 rate is calculated

Each of 25035’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 · 25035

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.46Practice expense 7.82Malpractice 1.59

16.8700 adjusted RVUs×$33.4009 conversion factor=$563.47

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25035

25035 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25035

Bone incision

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 25035

Bone incision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

25035 without 50 · national facility

$563.47

Bone incision

25035-50 · Bilateral: 150%

$845.21

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

25035 compared with similar codes

Compare codes

25035 vs 25028 vs 25031 vs 25040: national Medicare rates

Swap in your local Medicare rate.

  • 25035
    Bone incision · 7.46 wRVU
    —
  • 25028
    Collection drainage · 5.26 wRVU
    —
  • 25031
    Bursal drainage · 4.15 wRVU
    —
  • 25040
    Wrist arthrotomy · 7.31 wRVU
    —

How to choose

25028Collection drainage
Choose 25035 for cortical access to infected forearm or wrist bone. Choose 25028 when drainage is directed at a deep soft-tissue abscess or hematoma.
25031Bursal drainage
25031 is directed at a forearm or wrist bursa; 25035 is directed at bone cortex.
25040Wrist arthrotomy
25040 describes an operation on the wrist or midcarpal joint. Use 25035 when the operative target is forearm or wrist bone.

Codes related to 25035

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

Codes related to 25035
CodeHow it relatesNational office range
Used instead
25028Collection drainageTargets a deep forearm or wrist soft-tissue abscess or hematoma rather than infected bone.No office rate
25031Bursal drainageApplies when the operative target is a forearm or wrist bursa.No office rate
25040Wrist arthrotomyApplies to an operation directed at the wrist or midcarpal joint rather than bone cortex.No office rate

25035 billing questions

When is this code preferable to a deep forearm or wrist abscess drainage code?

Use this code when the surgeon opens the bone cortex to address infected bone. A deep soft-tissue abscess without bone work points to a soft-tissue drainage code instead.

Does it describe drainage of a wrist joint or bursa?

No. The target is bone cortex; a procedure directed at the wrist joint or a bursa is coded according to that structure and the work performed.

What documentation supports reporting it?

Document the affected forearm or wrist bone, laterality, the bone infection or abscess being treated, and the cortical incision and work performed.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How is it paid when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are 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 25035PPRRVU2026_Oct_nonQPP.csv, line 2,376 (RVU26D)

Open CMS sourceHow we calculate rates

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