FeeBase
Log inGet started
Menu

Billing code 25272: Tendon repairMedicare rate & RVUs

Reports secondary repair of a single extensor tendon or muscle in the forearm or wrist, such as delayed reconstruction after an earlier injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities121 Medicare services in 2024

Medicare pays $535.75 for 25272 nationally in a facility.

Medicare rate · 25272

Tendon repair

Swap in your local Medicare rate.

Work RVUs
7.03
Total RVUs
16.04
Global days
090

National rate · 2026

$535.75

Facility setting, before claim adjustments.

See every locality for 25272 → · 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 25272 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 25272 covers

This service covers secondary repair of one extensor tendon or muscle in the forearm or wrist. It is typically performed by an orthopedic, plastic, or hand surgeon when an extensor structure needs repair after the primary repair opportunity, including delayed treatment of an injury. The operative report should identify the structure and site and explain the secondary nature of the repair.

Select this code for one extensor tendon or muscle when the surgeon documents a secondary repair, rather than a primary repair or repair of a flexor structure. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of 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 25272 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

25272 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$482.86
Alaska*Unavailable$647.31
ArizonaUnavailable$520.84
ArkansasUnavailable$476.31
AtlantaUnavailable$550.42
AustinUnavailable$545.17
BakersfieldUnavailable$545.03
Baltimore/Surr. CntysUnavailable$569.58
BeaumontUnavailable$509.60
BrazoriaUnavailable$524.49

25272 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
25272 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 25272 rate is calculated

Each of 25272’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 · 25272

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.03Practice expense 7.53Malpractice 1.48

16.0400 adjusted RVUs×$33.4009 conversion factor=$535.75

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

Payment rules and modifiers for 25272

25272 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25272

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)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 · 25272

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

25272 without 51 · national facility

$535.75

Tendon repair

25272-51 · Second procedure: 50%

$267.88

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

25272 compared with similar codes

Compare codes

25272 vs 25270 vs 25263 vs 25274: national Medicare rates

Swap in your local Medicare rate.

  • 25272
    Tendon repair · 7.03 wRVU
    —
  • 25270
    Extensor tendon repair · 6.02 wRVU
    —
  • 25263
    Tendon repair · 7.84 wRVU
    —
  • 25274
    Tendon repair · 8.72 wRVU
    —

How to choose

25270Extensor tendon repair
Both concern extensor structures in the forearm or wrist. Choose 25270 for a primary repair and 25272 for a secondary repair.
25263Tendon repair
This is the secondary-repair counterpart for a flexor tendon or muscle; 25272 is for an extensor structure.
25274Tendon repair
25274 is for an additional tendon or muscle in the primary extensor-repair series; 25272 describes secondary repair.

Codes related to 25272

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

Codes related to 25272
CodeHow it relatesNational office range
Same family
25263Tendon repairSecondary repair of a flexor rather than extensor tendon or muscle.No office rate
25274Tendon repairExtensor repair code for an additional tendon or muscle in the primary-repair series.No office rate
Used instead
25270Extensor tendon repairPrimary repair of an extensor tendon or muscle in the same region.No office rate
25260Flexor tendon repairPrimary repair of a flexor tendon or muscle in the forearm or wrist.No office rate

25272 billing questions

How does this differ from 25270?

25270 is for primary repair of an extensor tendon or muscle in the forearm or wrist. Use 25272 when the documented repair is secondary.

How does this differ from 25263?

25263 describes secondary repair of a flexor tendon or muscle. This code is for an extensor structure.

What documentation supports secondary repair?

Document the repaired tendon or muscle, its forearm or wrist location, and why the procedure is secondary rather than primary.

Does the global period include postoperative visits?

Yes. The 90-day global period includes related postoperative care and the preoperative visit on the day before surgery.

Can modifier 50 be reported?

No. Bilateral adjustment is inappropriate for this code.

When is assistant-at-surgery payment allowed?

Only when the record documents 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 25272PPRRVU2026_Oct_nonQPP.csv, line 2,422 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 25272 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 25272 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 →