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Billing code 25400: Forearm bone repairMedicare rate & RVUs

Reports operative repair of a radius or ulna fracture nonunion or malunion when one forearm bone is treated without a graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities1K Medicare services in 2024

Medicare pays $737.16 for 25400 nationally in a facility.

Medicare rate · 25400

Forearm bone repair

Swap in your local Medicare rate.

Work RVUs
11
Total RVUs
22.07
Global days
090

National rate · 2026

$737.16

Facility setting, before claim adjustments.

See every locality for 25400 → · 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 25400 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 25400 covers

This operation treats a radius or ulna fracture that has failed to unite or has healed in a position requiring correction. An orthopedic surgeon works on the affected forearm bone to address the nonunion or malalignment and restore stability. The service is typically performed in an operating room, including a hospital outpatient department or inpatient setting, rather than as routine fracture follow-up.

Report this code when the repair involves one bone and is performed without a graft; use the applicable family code when both bones or grafting are involved. The operative report should identify the bone, the nonunion or malunion being treated, and the repair performed. The 90-day global period includes 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 25400 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

25400 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$668.65
Alaska*Unavailable$907.81
ArizonaUnavailable$717.54
ArkansasUnavailable$660.21
AtlantaUnavailable$757.52
AustinUnavailable$746.93
BakersfieldUnavailable$744.50
Baltimore/Surr. CntysUnavailable$781.86
BeaumontUnavailable$705.25
BrazoriaUnavailable$721.55

25400 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
25400 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 25400 rate is calculated

Each of 25400’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 · 25400

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.00Practice expense 8.91Malpractice 2.16

22.0700 adjusted RVUs×$33.4009 conversion factor=$737.16

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

Payment rules and modifiers for 25400

25400 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25400

Forearm bone 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)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 · 25400

Forearm bone 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

25400 without 50 · national facility

$737.16

Forearm bone repair

25400-50 · Bilateral: 150%

$1,105.74

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

25400 compared with similar codes

Compare codes

25400 vs 25405 vs 25415 vs 25420: national Medicare rates

Swap in your local Medicare rate.

  • 25400
    Forearm bone repair · 11 wRVU
    —
  • 25405
    Forearm bone repair · 14.63 wRVU
    —
  • 25415
    Forearm bone repair · 13.46 wRVU
    —
  • 25420
    Forearm repair · 16.61 wRVU
    —

How to choose

25405Forearm bone repair
Both codes address a nonunion or malunion of one radius or ulna; 25405 is the grafted repair, while 25400 is for repair without a graft.
25415Forearm bone repair
Use 25415 when the repair involves both the radius and ulna without graft, rather than a single forearm bone.
25420Forearm repair
25420 covers grafted repair involving both the radius and ulna; 25400 is for one bone without graft.

Codes related to 25400

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

Codes related to 25400
CodeHow it relatesNational office range
Same family
25405Forearm bone repairGrafted repair of a nonunion or malunion of one radius or ulna.No office rate
25415Forearm bone repairRepair of nonunion or malunion involving both the radius and ulna without graft.No office rate
25420Forearm repairGrafted repair of nonunion or malunion involving both the radius and ulna.No office rate

25400 billing questions

When is 25400 appropriate instead of 25405?

Use 25400 for a one-bone radius or ulna repair without a graft. The grafted one-bone repair is represented by 25405.

Can 25400 be reported for both the radius and ulna?

When both forearm bones are repaired, the family includes codes for repair of the radius and ulna together. Do not use 25400 twice to represent that service.

What documentation supports 25400?

Document which bone is repaired, the nonunion or malunion being treated, and the operative work performed. The record should also support that the repair is without a graft.

How does the bilateral payment rule affect reporting?

For bilateral performance, report modifier 50; CMS lists payment at 150%. The operative documentation should support repair on both sides.

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 in that session are paid at 50%.

Is an assistant or co-surgeon reportable for this operation?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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 25400PPRRVU2026_Oct_nonQPP.csv, line 2,449 (RVU26D)

Open CMS sourceHow we calculate rates

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