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Billing code 25275: Tendon repairMedicare rate & RVUs

Reports repair of an extensor tendon at the forearm or wrist when the procedure includes transplantation of the tendon sheath.

CMS RVU26DEffective Oct 1, 2026109 payment localities315 Medicare services in 2024

Medicare pays $623.93 for 25275 nationally in a facility.

Medicare rate · 25275

Tendon repair

Swap in your local Medicare rate.

Work RVUs
8.74
Total RVUs
18.68
Global days
090

National rate · 2026

$623.93

Facility setting, before claim adjustments.

See every locality for 25275 → · 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 25275 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 25275 covers

An orthopedic or hand surgeon uses this service to repair an extensor tendon in the forearm or wrist while transplanting or reconstructing its sheath. The sheath work distinguishes the procedure from a repair limited to tendon tissue. It is generally performed in an operating room for an injury or other tendon problem requiring both tendon repair and sheath reconstruction.

Select the code when the operative report supports extensor tendon repair with tendon sheath transplantation; document the affected side, tendon, and work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 identifies a bilateral procedure, paid at 150%. Assistant-at-surgery payment requires medical-necessity documentation, and co-surgeon payment requires supporting documentation; team surgery is 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 25275 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

25275 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$565.30
Alaska*Unavailable$762.97
ArizonaUnavailable$607.37
ArkansasUnavailable$558.04
AtlantaUnavailable$640.37
AustinUnavailable$634.23
BakersfieldUnavailable$634.35
Baltimore/Surr. CntysUnavailable$661.93
BeaumontUnavailable$595.10
BrazoriaUnavailable$611.58

25275 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
25275 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 25275 rate is calculated

Each of 25275’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 · 25275

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.74Practice expense 8.28Malpractice 1.66

18.6800 adjusted RVUs×$33.4009 conversion factor=$623.93

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

Payment rules and modifiers for 25275

25275 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25275

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)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)1Permitted with supporting documentation.
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 · 25275

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 50 · payment effect

With and without the modifier

25275 without 50 · national facility

$623.93

Tendon repair

25275-50 · Bilateral: 150%

$935.89

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

25275 compared with similar codes

Compare codes

25275 vs 25274 vs 25270 vs 25272 vs 25295: national Medicare rates

Swap in your local Medicare rate.

  • 25275
    Tendon repair · 8.74 wRVU
    —
  • 25274
    Tendon repair · 8.72 wRVU
    —
  • 25270
    Extensor tendon repair · 6.02 wRVU
    —
  • 25272
    Tendon repair · 7.03 wRVU
    —
  • 25295
    Tendon release · 6.55 wRVU
    —

How to choose

25274Tendon repair
Choose 25275 when the extensor tendon repair includes tendon sheath transplantation. Choose 25274 for repair with a free tendon graft.
25270Extensor tendon repair
25270 describes primary extensor tendon repair without the sheath-transplantation feature. The sheath transplantation is the distinguishing work for 25275.
25272Tendon repair
25272 describes secondary extensor tendon repair without the sheath-transplantation feature. Report 25275 when the repair includes tendon sheath transplantation.
25295Tendon release
25295 addresses release of a tendon to free it from adhesions. It is not the tendon repair with sheath transplantation represented by 25275.

Codes related to 25275

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

Codes related to 25275
CodeHow it relatesNational office range
Same family
25270Extensor tendon repairExtensor tendon repair without the sheath-transplantation distinction.No office rate
25272Tendon repairSecondary extensor tendon repair without the sheath-transplantation distinction.No office rate
25274Tendon repairExtensor tendon repair using a free graft.No office rate

25275 billing questions

How is this different from 25274?

25275 is for extensor tendon repair that includes tendon sheath transplantation. Use 25274 when the repair uses a free tendon graft rather than the sheath-transplantation service.

Can the tendon repair and sheath work be reported separately?

The defining service includes extensor tendon repair with tendon sheath transplantation. The operative report should establish that combination rather than describe tendon repair alone.

What documentation supports reporting 25275?

Document the forearm or wrist site, the extensor tendon repaired, and the tendon sheath transplantation or reconstruction performed. The operative note should make clear how the sheath work was part of the repair.

How is a bilateral procedure reported?

Use modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.

Can an assistant surgeon or co-surgeon be paid?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is 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 25275PPRRVU2026_Oct_nonQPP.csv, line 2,424 (RVU26D)

Open CMS sourceHow we calculate rates

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