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Billing code 25260: Flexor tendon repairMedicare rate & RVUs

Reports primary repair of a flexor tendon or muscle in the forearm or wrist, using direct repair without a free tendon graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities823 Medicare services in 2024

Medicare pays $599.21 for 25260 nationally in a facility.

Medicare rate · 25260

Flexor tendon repair

Swap in your local Medicare rate.

Work RVUs
7.84
Total RVUs
17.94
Global days
090

National rate · 2026

$599.21

Facility setting, before claim adjustments.

See every locality for 25260 → · 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 25260 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 25260 covers

25260 describes primary repair of a flexor tendon or muscle in the forearm or wrist, with the tendon ends repaired directly rather than using a free graft. A typical case is surgical repair of a flexor tendon lacerated in the forearm or wrist. Hand, orthopedic, and plastic surgeons commonly perform the procedure in an operating room or hospital outpatient surgery setting. The code is reported for each tendon or muscle repaired, so the operative report should identify the structures treated.

Select this code when the service is a primary flexor repair without a free graft; document the injury, site, tendon or muscle, and repair performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Medicare does not pay an assistant at surgery for this code; 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 25260 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

25260 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$541.46
Alaska*Unavailable$726.15
ArizonaUnavailable$583.06
ArkansasUnavailable$534.30
AtlantaUnavailable$614.73
AustinUnavailable$610.63
BakersfieldUnavailable$612.01
Baltimore/Surr. CntysUnavailable$636.30
BeaumontUnavailable$569.81
BrazoriaUnavailable$587.63

25260 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
25260 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 25260 rate is calculated

Each of 25260’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 · 25260

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.84Practice expense 8.59Malpractice 1.51

17.9400 adjusted RVUs×$33.4009 conversion factor=$599.21

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

Payment rules and modifiers for 25260

25260 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25260

Flexor tendon repair

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
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 · 25260

Flexor tendon repair

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 51 · payment effect

With and without the modifier

25260 without 51 · national facility

$599.21

Flexor tendon repair

25260-51 · Second procedure: 50%

$299.61

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

25260 compared with similar codes

Compare codes

25260 vs 25263 vs 25265 vs 25270 vs 25274: national Medicare rates

Swap in your local Medicare rate.

  • 25260
    Flexor tendon repair · 7.84 wRVU
    —
  • 25263
    Tendon repair · 7.84 wRVU
    —
  • 25265
    Flexor tendon repair · 9.85 wRVU
    —
  • 25270
    Extensor tendon repair · 6.02 wRVU
    —
  • 25274
    Tendon repair · 8.72 wRVU
    —

How to choose

25263Tendon repair
25263 describes secondary repair of a forearm or wrist flexor tendon or muscle without a free graft. Choose 25260 for primary repair.
25265Flexor tendon repair
25265 is for secondary flexor repair using a free graft. 25260 is primary repair without a free graft.
25270Extensor tendon repair
25270 is the primary, no-free-graft repair code for extensor tendons or muscles; 25260 is for flexors.
25274Tendon repair
25274 describes secondary extensor repair using a free graft. 25260 describes primary flexor repair without a free graft.

Codes related to 25260

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

Codes related to 25260
CodeHow it relatesNational office range
Same family
25263Tendon repairSecondary flexor repair without a free graft.No office rate
25265Flexor tendon repairSecondary flexor repair using a free graft.No office rate
25270Extensor tendon repairPrimary repair of an extensor tendon or muscle in the forearm or wrist.No office rate
25272Tendon repairSecondary extensor repair without a free graft.No office rate
25274Tendon repairSecondary extensor repair using a free graft.No office rate

25260 billing questions

When is 25260 appropriate instead of 25263?

Use 25260 for primary repair of a forearm or wrist flexor tendon or muscle without a free graft. Code 25263 describes a secondary repair without a free graft.

How does 25260 differ from 25265?

25260 is for primary repair without a free graft. 25265 is for secondary repair using a free graft.

What should the operative report identify?

Document the forearm or wrist site, the flexor tendon or muscle repaired, and that the service was a primary repair without a free graft. Identify each structure repaired because the code is reported per tendon or muscle.

How does Medicare treat multiple procedures performed in the same session?

Medicare pays the highest-valued procedure in full and reduces the other procedures to 50% when multiple procedures are performed in the same session.

Can an assistant or co-surgeon be reported for 25260?

Medicare does not pay an assistant at surgery for this code. 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 25260PPRRVU2026_Oct_nonQPP.csv, line 2,418 (RVU26D)

Open CMS sourceHow we calculate rates

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