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Billing code 25290: Tendon divisionMedicare rate & RVUs

Surgical division of one wrist or forearm flexor or extensor tendon to address contracture or tethering, reported for each tendon treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.2K Medicare services in 2024

Medicare pays $414.51 for 25290 nationally in a facility.

Medicare rate · 25290

Tendon division

Swap in your local Medicare rate.

Work RVUs
5.29
Total RVUs
12.41
Global days
090

National rate · 2026

$414.51

Facility setting, before claim adjustments.

See every locality for 25290 → · 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 25290 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 25290 covers

This service involves surgically dividing a flexor or extensor tendon in the wrist or forearm, typically to reduce tendon tightness contributing to a contracture or deformity. It is generally performed by an orthopedic or hand surgeon in an operating room. The operative report should identify the tendon and site and describe the reason for division; distinguish this procedure from tendon repair, lengthening, or freeing adhesions around an intact tendon.

Report the service for each tendon divided, supported by the operative documentation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment is statutorily restricted, and 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 25290 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

25290 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$374.35
Alaska*Unavailable$500.97
ArizonaUnavailable$403.32
ArkansasUnavailable$369.37
AtlantaUnavailable$425.08
AustinUnavailable$422.85
BakersfieldUnavailable$424.26
Baltimore/Surr. CntysUnavailable$440.23
BeaumontUnavailable$393.74
BrazoriaUnavailable$406.66

25290 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
25290 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 25290 rate is calculated

Each of 25290’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 · 25290

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.29Practice expense 6.11Malpractice 1.01

12.4100 adjusted RVUs×$33.4009 conversion factor=$414.51

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

Payment rules and modifiers for 25290

25290 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25290

Tendon division

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 · 25290

Tendon division

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

25290 without 51 · national facility

$414.51

Tendon division

25290-51 · Second procedure: 50%

$207.26

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

25290 compared with similar codes

Compare codes

25290 vs 25280 vs 25295 vs 25260 vs 25270: national Medicare rates

Swap in your local Medicare rate.

  • 25290
    Tendon division · 5.29 wRVU
    —
  • 25280
    Tendon adjustment · 7.21 wRVU
    —
  • 25295
    Tendon release · 6.55 wRVU
    —
  • 25260
    Flexor tendon repair · 7.84 wRVU
    —
  • 25270
    Extensor tendon repair · 6.02 wRVU
    —

How to choose

25280Tendon adjustment
Choose 25290 for division of the tendon. Choose 25280 when the surgeon performs tendon lengthening or shortening.
25295Tendon release
25295 describes freeing a tendon from adhesions to improve glide; 25290 describes dividing the tendon.
25260Flexor tendon repair
25260 is for primary repair of a flexor tendon. Use 25290 when the documented procedure is tendon division, not restoration of a lacerated tendon.
25270Extensor tendon repair
25270 is for primary repair of an extensor tendon. Use 25290 when the documented procedure is tendon division rather than repair.

Codes related to 25290

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

Codes related to 25290
CodeHow it relatesNational office range
Used instead
25280Tendon adjustmentUsed when the surgeon lengthens or shortens a tendon rather than dividing it.No office rate
25295Tendon releaseFrees a tendon from adhesions when restricted glide, rather than tendon division, is treated.No office rate
25260Flexor tendon repairPrimary flexor tendon repair restores a lacerated tendon rather than intentionally dividing it.No office rate
25270Extensor tendon repairPrimary extensor tendon repair restores a lacerated tendon rather than intentionally dividing it.No office rate

25290 billing questions

How is this different from tendon lengthening or shortening?

This service reports tendon division. Use 25280 when the surgeon lengthens or shortens the tendon rather than dividing it.

How is this different from tenolysis?

Tenolysis, reported with 25295, frees a tendon from adhesions that restrict its glide. This code is for dividing the tendon itself.

How many units should be reported?

Report each tendon treated as supported by the operative note. Document the tendon, wrist or forearm site, and the procedure performed.

Is modifier 50 appropriate?

No. Modifier 50 is inappropriate for this service; document the treated tendon or tendons and report according to the code’s each-tendon basis.

What postoperative care is included?

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

Can an assistant or co-surgeon be paid for this procedure?

Assistant-at-surgery payment is statutorily restricted. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

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 25290PPRRVU2026_Oct_nonQPP.csv, line 2,426 (RVU26D)

Open CMS sourceHow we calculate rates

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