Billing code 25530: Fracture treatmentMedicare rate & RVUs

Medicare pays $301.94 for 25530 nationally in the office and $254.18 in a hospital or facility. Local office rates run $264.58–$397.91.

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

What 25530 covers

This service covers definitive nonsurgical care for a fracture through the shaft of the ulna when the treating clinician accepts the alignment and does not manipulate the fracture. An orthopedist, orthopedic trauma specialist, or other qualified physician may select this approach after evaluating imaging and the injury. Care commonly includes immobilization with a cast or splint and fracture-related follow-up. It is specific to the ulna shaft, not a fracture of the radius or both forearm bones.

Select the code according to the bone and treatment performed, not displacement alone. If the clinician manipulates the fracture, use the corresponding manipulation code; open fixation is a different service. The 90-day global period includes 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 others at 50%. Modifier 50 for bilateral procedures is paid at 150%. CMS does not pay an assistant at surgery and does not permit co-surgeons or team surgery for this code.

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 25530 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

25530 rates by state

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

How the 25530 rate is calculated

Each of 25530’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 25530

25530 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

25530 compared with similar codes

How to choose

25535Fracture treatment

Both codes address an ulnar shaft fracture. Choose 25530 when no manipulation is performed and 25535 when the clinician manipulates the fracture.

25545Fracture fixation

25530 describes nonsurgical fracture care without manipulation; 25545 is for open treatment with internal fixation.

25500Radial fracture care

25500 is for a radial shaft fracture treated without manipulation. Use 25530 when the fracture involves the ulnar shaft.

25560Forearm fracture care

25560 applies when both the radius and ulna shafts are fractured and treated without manipulation; 25530 is for the ulna shaft alone.

Codes related to 25530

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