Billing code 25425: Forearm bone repairMedicare rate & RVUs

Medicare pays $891.14 for 25425 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 25425 covers

This code describes graft-assisted reconstruction of a nonunion or malunion in one forearm bone: the radius or the ulna. An orthopedic surgeon may use it when a prior fracture has failed to unite or has healed in a position requiring operative correction and grafting. The work takes place in the operating room and addresses the affected bone rather than a wrist joint or carpal bone. The operative report should identify the bone, the nonunion or malunion, the grafting performed, and the repair technique.

Select this code only when the documented operation matches its specific billing code descriptor; distinguish repair of one bone from procedures addressing both radius and ulna, and distinguish the applicable graft technique from other repair options. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 25425 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

25425 rates by state

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

How the 25425 rate is calculated

Each of 25425’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 25425

25425 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

25425 compared with similar codes

How to choose

25400Forearm bone repair

This code is a graft-associated repair option for a radius or ulna. Use 25400 when the documented procedure matches that code’s repair approach instead.

25405Forearm bone repair

Both concern repair of a radius or ulna nonunion or malunion; determine the correct code from the graft and operative details specified in the full billing code descriptors.

25420Forearm repair

25420 concerns repair and grafting of both radius and ulna. This code addresses a radius or ulna rather than the pair.

25426Forearm bone repair

The key distinction is the number of bones treated: this code is associated with radius or ulna, while 25426 is associated with both.

Codes related to 25425

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

Open CMS sourceHow we calculate rates