Billing code 25365: Forearm osteotomyMedicare rate & RVUs

Medicare pays $851.05 for 25365 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 25365 covers

This procedure corrects alignment or deformity by cutting and repositioning both the radius and ulna. An orthopedic or hand surgeon may perform it for a forearm malunion or another acquired or developmental deformity affecting both bones. It is an operative bone procedure, typically performed in a hospital or ambulatory surgery setting; fixation may be used to maintain the corrected position.

Report this code when the operative documentation supports osteotomy of both bones, not just one. The record should identify the treated side, the deformity or malalignment, and the correction performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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 reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 25365 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

25365 rates by state

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

How the 25365 rate is calculated

Each of 25365’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.

Payment rules and modifiers for 25365

25365 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

25365 compared with similar codes

How to choose

25350Radius osteotomy

This code addresses both radius and ulna. Code 25350 is for an osteotomy involving the radius alone.

25360Ulnar osteotomy

This code addresses both forearm bones. Code 25360 is for an osteotomy involving the ulna alone.

25375Forearm osteotomy

Use 25375 when the documented paired-bone osteotomy includes lengthening; this code describes corrective osteotomy of both bones without that specific lengthening distinction.

25392Forearm osteotomy

Code 25392 describes shortening both radius and ulna. Choose this code when shortening, rather than another corrective alignment procedure, is the documented objective.

Codes related to 25365

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

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

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