FeeBase
Log inGet started
Menu

Billing code 25265: Flexor tendon repairMedicare rate & RVUs

Reports secondary repair of a forearm or wrist flexor tendon when reconstruction requires a free tendon graft, including graft harvest.

CMS RVU26DEffective Oct 1, 2026109 payment localities175 Medicare services in 2024

Medicare pays $688.06 for 25265 nationally in a facility.

Medicare rate · 25265

Flexor tendon repair

Work RVUs
9.85
Total RVUs
20.60
Global days
090

National rate · 2026

$688.06

Facility setting, before claim adjustments.

See every locality for 25265 →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 25265 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 25265 covers

This operation reconstructs a flexor tendon in the forearm or wrist during a secondary repair, using a free graft to bridge or replace damaged tendon. A hand or orthopedic surgeon may perform it when a tendon cannot be repaired directly, such as after a delayed presentation or a prior repair that did not restore continuity. The surgeon obtains and places the graft as part of the reconstruction, then secures it to restore the tendon’s path and function.

Report the code for each flexor tendon repaired; the operative note should identify the tendon, the secondary nature of the repair, and use of a free graft. Graft harvest is included. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code’s descriptor and anatomy. CMS permits assistant-at-surgery payment; 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 25265 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

25265 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$624.19
Alaska*Unavailable$844.31
ArizonaUnavailable$669.98
ArkansasUnavailable$616.29
AtlantaUnavailable$706.16
AustinUnavailable$698.97
BakersfieldUnavailable$698.85
Baltimore/Surr. CntysUnavailable$729.61
BeaumontUnavailable$656.91
BrazoriaUnavailable$674.49

25265 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
25265 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 25265 rate is calculated

Each of 25265’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 · 25265

RVUs × geographic indexes × conversion factor

Work9.85

9.85 RVUs× 1.000 GPCI

Practice expense8.91

8.91 RVUs× 1.000 GPCI

Malpractice1.84

1.84 RVUs× 1.000 GPCI

Adjusted RVUs

20.6000

Conversion factor

$33.4009

Medicare rate

$688.06

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

Payment rules and modifiers for 25265

25265 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25265

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)2Paid.
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 · 25265

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.

  • 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 51 · payment effect

With and without the modifier

25265 without 51 · national facility

$688.06

Flexor tendon repair

25265-51 · Second procedure: 50%

$344.03

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

25265 compared with similar codes

Compare codes · National

5 codes, side by side

  • 25265

    Flexor tendon repair9.85 wRVU

    Not priced

  • 25263

    Tendon repair7.84 wRVU

    Not priced

  • 25260

    Flexor tendon repair7.84 wRVU

    Not priced

  • 25274

    Tendon repair8.72 wRVU

    Not priced

  • 25272

    Tendon repair7.03 wRVU

    Not priced

How to choose

25263Tendon repair
Both describe secondary flexor tendon repair in the forearm or wrist. Choose 25265 when the reconstruction uses a free graft; choose 25263 when it does not.
25260Flexor tendon repair
25260 is for primary flexor tendon repair without a graft. 25265 is for secondary repair requiring a free graft.
25274Tendon repair
25274 covers secondary extensor tendon repair with a free graft. 25265 is for a flexor tendon.
25272Tendon repair
25272 is secondary extensor tendon repair without a graft; 25265 is secondary flexor tendon repair with a free graft.

Codes related to 25265

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

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

25265 billing questions

When is 25265 selected instead of 25263?

Use 25265 for a secondary flexor tendon repair that uses a free graft. Code 25263 describes secondary flexor tendon repair without a graft.

Is graft harvest separately reportable?

No. The graft harvest is included in 25265.

How many units should be reported?

Report one unit for each flexor tendon repaired. The operative report should identify the tendon or tendons treated.

Should modifier 50 be used for repairs on both sides?

No. The descriptor and anatomy make modifier 50 inappropriate; report the tendon repairs rather than a bilateral procedure.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

Can an assistant surgeon be reported?

CMS permits assistant-at-surgery payment for this procedure. 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 25265PPRRVU2026_Oct_nonQPP.csv, line 2,420 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 25265 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 25265 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →