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Billing code 25393: Forearm lengtheningMedicare rate & RVUs

Surgical lengthening of both the radius and ulna in one forearm, reported when the operative treatment addresses shortening or a length discrepancy in both bones.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $1,033.09 for 25393 nationally in a facility.

Medicare rate · 25393

Forearm lengthening

Swap in your local Medicare rate.

Work RVUs
16.15
Total RVUs
30.93
Global days
090

National rate · 2026

$1,033.09

Facility setting, before claim adjustments.

See every locality for 25393 → · 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 25393 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 25393 covers

This procedure surgically lengthens both bones of the forearm. An orthopedic or hand surgeon may perform it to address a forearm that is shortened or has a length discrepancy involving both the radius and ulna, such as after a growth disturbance or injury. The operation is generally performed in a hospital operating room, with the operative plan directed at correcting the length of both bones.

Report this code when the operative documentation supports lengthening both the radius and ulna; lengthening only one bone points to a different code in the family. Document the indication, side, and work performed on each bone. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 25393 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

25393 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$935.88
Alaska*Unavailable$1,275.83
ArizonaUnavailable$1,004.80
ArkansasUnavailable$923.96
AtlantaUnavailable$1,063.86
AustinUnavailable$1,043.04
BakersfieldUnavailable$1,034.77
Baltimore/Surr. CntysUnavailable$1,096.60
BeaumontUnavailable$990.84
BrazoriaUnavailable$1,008.72

25393 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
25393 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 25393 rate is calculated

Each of 25393’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 · 25393

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.15Practice expense 11.34Malpractice 3.44

30.9300 adjusted RVUs×$33.4009 conversion factor=$1,033.09

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

Payment rules and modifiers for 25393

25393 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25393

Forearm lengthening

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)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 · 25393

Forearm lengthening

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

25393 without 50 · national facility

$1,033.09

Forearm lengthening

25393-50 · Bilateral: 150%

$1,549.64

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

25393 compared with similar codes

Compare codes

25393 vs 25391 vs 25392 vs 25390: national Medicare rates

Swap in your local Medicare rate.

  • 25393
    Forearm lengthening · 16.15 wRVU
    —
  • 25391
    Bone lengthening · 13.92 wRVU
    —
  • 25392
    Forearm osteotomy · 14.22 wRVU
    —
  • 25390
    Bone shortening · 10.43 wRVU
    —

How to choose

25391Bone lengthening
Choose 25391 when only the radius or only the ulna is lengthened. This code is for lengthening both bones.
25392Forearm osteotomy
Both codes address both forearm bones, but 25392 is for shortening and this code is for lengthening.
25390Bone shortening
25390 shortens one forearm bone; this code lengthens both the radius and ulna.

Codes related to 25393

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

Codes related to 25393
CodeHow it relatesNational office range
Same family
25391Bone lengtheningLengthening is performed on the radius or ulna rather than both bones.No office rate
25390Bone shorteningShortens one forearm bone rather than lengthening both.No office rate
25392Forearm osteotomyShortens both forearm bones rather than lengthening them.No office rate

25393 billing questions

When should this be selected instead of 25391?

Use this code when the surgeon lengthens both the radius and ulna. Code 25391 describes lengthening one of those bones.

Can the procedure be reported bilaterally?

Yes. CMS identifies it as a bilateral procedure; modifier 50 is paid at 150%.

What documentation supports this code?

The operative report should identify the indication and side, and establish that the surgeon lengthened both the radius and ulna.

How does the global period affect postoperative reporting?

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

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted 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 25393PPRRVU2026_Oct_nonQPP.csv, line 2,447 (RVU26D)

Open CMS sourceHow we calculate rates

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