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Billing code 25394: Carpal osteotomyMedicare rate & RVUs

Reports an operation that shortens a carpal bone, such as the lunate, to address selected wrist disorders involving carpal bone mechanics.

CMS RVU26DEffective Oct 1, 2026109 payment localities45 Medicare services in 2024

Medicare pays $735.49 for 25394 nationally in a facility.

Medicare rate · 25394

Carpal osteotomy

Swap in your local Medicare rate.

Work RVUs
10.58
Total RVUs
22.02
Global days
090

National rate · 2026

$735.49

Facility setting, before claim adjustments.

See every locality for 25394 → · 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 25394 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 25394 covers

This service involves surgically removing or reshaping bone to shorten a carpal bone, such as the lunate. A hand or orthopedic surgeon may perform it for selected wrist conditions in which changing carpal bone length is part of the treatment plan; lunate disorders such as Kienböck disease are one clinical context. The operative report should identify the bone and describe the shortening procedure performed.

Report this code for shortening a carpal bone, not for an osteotomy that shortens the radius or ulna. Documentation should support the affected bone, side, indication, and procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and 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 25394 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

25394 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$664.50
Alaska*Unavailable$898.39
ArizonaUnavailable$715.15
ArkansasUnavailable$655.76
AtlantaUnavailable$756.56
AustinUnavailable$745.43
BakersfieldUnavailable$742.29
Baltimore/Surr. CntysUnavailable$781.36
BeaumontUnavailable$702.53
BrazoriaUnavailable$719.02

25394 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
25394 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 25394 rate is calculated

Each of 25394’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 · 25394

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.58Practice expense 9.19Malpractice 2.25

22.0200 adjusted RVUs×$33.4009 conversion factor=$735.49

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

Payment rules and modifiers for 25394

25394 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25394

Carpal osteotomy

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)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 · 25394

Carpal osteotomy

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

25394 without 50 · national facility

$735.49

Carpal osteotomy

25394-50 · Bilateral: 150%

$1,103.24

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

25394 compared with similar codes

Compare codes

25394 vs 25390 vs 25392 vs 25391: national Medicare rates

Swap in your local Medicare rate.

  • 25394
    Carpal osteotomy · 10.58 wRVU
    —
  • 25390
    Bone shortening · 10.43 wRVU
    —
  • 25392
    Forearm osteotomy · 14.22 wRVU
    —
  • 25391
    Bone lengthening · 13.92 wRVU
    —

How to choose

25390Bone shortening
Choose 25390 when the operation shortens the radius or ulna. This code is for shortening a carpal bone.
25392Forearm osteotomy
25392 covers shortening both forearm bones; this code applies when the shortened bone is carpal.
25391Bone lengthening
25391 is for lengthening a radius or ulna. This code describes shortening a carpal bone.

Codes related to 25394

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

Codes related to 25394
CodeHow it relatesNational office range
Same family
25390Bone shorteningShortening an individual radius or ulna is reported when the forearm bone, rather than a carpal bone, is treated.No office rate
25392Forearm osteotomyShortening both radius and ulna differs in the bones treated.No office rate
25391Bone lengtheningLengthening a radius or ulna is a related forearm osteotomy with the opposite length-change goal.No office rate
25393Forearm lengtheningLengthening both radius and ulna differs in site and length-change goal.No office rate

25394 billing questions

How does this differ from a forearm-bone shortening code?

This code is for shortening a carpal bone in the wrist. Use the radius or ulna codes when the osteotomy shortens one or both forearm bones.

What should the operative report identify?

Document the carpal bone treated, the side, the clinical indication, and the shortening procedure performed.

Can modifier 50 be used for bilateral work?

Yes. CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and additional procedures are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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 25394PPRRVU2026_Oct_nonQPP.csv, line 2,448 (RVU26D)

Open CMS sourceHow we calculate rates

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