Billing code 25565: Forearm fracture careMedicare rate & RVUs
Reports closed manipulation and treatment of shaft fractures of both the radius and ulna, such as a displaced both-bone forearm fracture.
Medicare pays $623.59 for 25565 nationally in the office and $509.70 in a hospital or facility. Local office rates run $547.46–$796.37.
Medicare rate · 25565
Forearm fracture care
Swap in your local Medicare rate.
- Work RVUs
- 5.7
- Total RVUs
- 18.67
- Global days
- 090
National rate · 2026
$623.59
Office setting, before claim adjustments.
See every locality for 25565 → · 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
What 25565 covers
This service covers closed treatment of shaft fractures of both forearm bones, the radius and ulna, when manipulation is performed to restore alignment. A typical case is a displaced both-bone forearm fracture managed without surgical exposure or internal fixation. An orthopedic surgeon commonly provides the reduction in an emergency department or fracture clinic, then immobilizes the arm and assesses alignment with imaging.
Report the code when the physician treats both shaft fractures with manipulation; documentation should identify both fractures and support the reduction performed. A single-bone fracture, treatment without manipulation, or operative fixation points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. For bilateral services reported with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted, and 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 25565 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$547.46 to $796.37
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $555.92 | $456.26 |
| Alaska* | $724.46 | $603.16 |
| Arizona | $605.22 | $494.85 |
| Arkansas | $547.46 | $449.62 |
| Atlanta | $639.19 | $523.47 |
| Austin | $641.58 | $521.07 |
| Bakersfield | $647.49 | $522.66 |
| Baltimore/Surr. Cntys | $665.44 | $543.23 |
| Beaumont | $585.44 | $481.79 |
| Brazoria | $611.99 | $499.11 |
| Chicago | $683.54 | $569.07 |
| Chico | $643.92 | $519.09 |
| Colorado | $641.22 | $520.04 |
| Connecticut | $666.58 | $543.91 |
| Dallas | $617.54 | $504.10 |
| Dc + Md/Va Suburbs | $708.14 | $573.97 |
| Delaware | $615.45 | $502.92 |
| Detroit | $639.98 | $530.07 |
| East St. Louis | $636.81 | $532.02 |
| El Centro | $644.14 | $519.30 |
| Fort Lauderdale | $664.01 | $548.63 |
| Fort Worth | $614.21 | $501.91 |
| Fresno | $643.92 | $519.09 |
| Galveston | $614.87 | $501.77 |
| Hanford-Corcoran | $643.92 | $519.09 |
| Hawaii, Guam | $658.53 | $529.03 |
| Houston | $638.84 | $525.74 |
| Idaho | $569.38 | $464.59 |
| Indiana | $572.67 | $467.09 |
| Iowa | $564.11 | $459.89 |
| Kansas | $564.50 | $461.54 |
| Kentucky | $576.65 | $475.39 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $687.97 | $553.23 |
| Madera | $643.92 | $519.09 |
| Manhattan | $724.51 | $592.16 |
| Merced | $643.92 | $519.09 |
| Metropolitan Boston | $702.14 | $566.15 |
| Metropolitan Kansas City | $598.83 | $491.88 |
| Metropolitan Philadelphia | $651.43 | $532.87 |
| Metropolitan St. Louis | $604.99 | $496.56 |
| Miami | $706.46 | $587.90 |
| Minnesota | $604.09 | $486.89 |
| Mississippi | $558.04 | $459.98 |
| Modesto | $643.92 | $519.09 |
| Montana** | $623.51 | $509.61 |
| Napa | $737.91 | $587.79 |
| Nebraska | $566.39 | $461.26 |
| Nevada** | $616.68 | $502.67 |
| New Hampshire | $634.09 | $515.53 |
| New Mexico | $600.06 | $495.62 |
| New Orleans | $606.57 | $499.39 |
| North Carolina | $581.71 | $475.44 |
| North Dakota** | $597.60 | $483.71 |
| Northern Nj | $700.88 | $568.76 |
| Nyc Suburbs/Long Island | $746.88 | $611.46 |
| Ohio | $590.06 | $486.07 |
| Oklahoma | $572.17 | $470.46 |
| Oxnard-Thousand Oaks-Ventura | $683.31 | $548.68 |
| Portland | $658.67 | $532.13 |
| Poughkpsie/N Nyc Suburbs | $678.35 | $553.63 |
| Puerto Rico | $627.22 | $512.07 |
| Queens | $726.00 | $591.37 |
| Redding | $643.92 | $519.09 |
| Rest Of California | $643.92 | $519.09 |
| Rest Of Florida | $628.47 | $519.58 |
| Rest Of Georgia | $589.93 | $488.34 |
| Rest Of Illinois | $614.35 | $510.36 |
| Rest Of Louisiana | $576.97 | $476.17 |
| Rest Of Maine | $575.90 | $471.11 |
| Rest Of Maryland | $626.58 | $511.32 |
| Rest Of Massachusetts | $638.40 | $518.47 |
| Rest Of Michigan | $595.36 | $491.37 |
| Rest Of Missouri | $568.71 | $470.53 |
| Rest Of New Jersey | $671.28 | $546.91 |
| Rest Of New York | $591.13 | $482.92 |
| Rest Of Oregon | $609.04 | $495.60 |
| Rest Of Pennsylvania | $589.25 | $484.70 |
| Rest Of Texas | $599.49 | $491.40 |
| Rest Of Washington | $636.25 | $516.32 |
| Rhode Island | $635.34 | $517.68 |
| Riverside-San Bernardino-Ontario | $657.98 | $533.15 |
| Sacramento-Roseville-Folsom | $673.63 | $541.17 |
| Salinas | $671.12 | $539.11 |
| San Diego-Chula Vista-Carlsbad | $685.60 | $549.38 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $777.69 | $617.09 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $776.20 | $615.60 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $796.37 | $632.13 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $790.29 | $626.05 |
| San Luis Obispo-Paso Robles | $660.66 | $530.93 |
| Santa Cruz-Watsonville | $691.02 | $552.64 |
| Santa Maria-Santa Barbara | $673.27 | $540.47 |
| Santa Rosa-Petaluma | $697.80 | $557.93 |
| Seattle (King Cnty) | $713.51 | $573.76 |
| South Carolina | $587.43 | $482.19 |
| South Dakota** | $594.54 | $480.64 |
| Southern Maine | $603.94 | $491.07 |
| Stockton | $643.92 | $519.09 |
| Suburban Chicago | $669.22 | $552.25 |
| Tennessee | $567.90 | $464.36 |
| Utah | $595.76 | $488.70 |
| Vallejo | $735.76 | $585.65 |
| Vermont | $598.09 | $485.33 |
| Virgin Islands | $627.22 | $512.07 |
| Virginia | $604.11 | $492.15 |
| Visalia | $643.92 | $519.09 |
| West Virginia | $591.43 | $492.46 |
| Wisconsin | $576.96 | $467.85 |
| Wyoming** | $612.22 | $498.32 |
| Yuba City | $643.92 | $519.09 |
25565 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$547.46
$724.46
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $724.46 | 1 |
| AL | $555.92 | 1 |
| AR | $547.46 | 1 |
| AZ | $605.22 | 1 |
| CA | $643.92–$796.37 | 29 |
| CO | $641.22 | 1 |
| CT | $666.58 | 1 |
| DC | $708.14 | 1 |
| DE | $615.45 | 1 |
| FL | $628.47–$706.46 | 3 |
| GA | $589.93–$639.19 | 2 |
| GU | $658.53 | 1 |
| HI | $658.53 | 1 |
| IA | $564.11 | 1 |
| ID | $569.38 | 1 |
| IL | $614.35–$683.54 | 4 |
| IN | $572.67 | 1 |
| KS | $564.50 | 1 |
| KY | $576.65 | 1 |
| LA | $576.97–$606.57 | 2 |
| MA | $638.40–$702.14 | 2 |
| MD | $626.58–$708.14 | 3 |
| ME | $575.90–$603.94 | 2 |
| MI | $595.36–$639.98 | 2 |
| MN | $604.09 | 1 |
| MO | $568.71–$604.99 | 3 |
| MS | $558.04 | 1 |
| MT | $623.51 | 1 |
| NC | $581.71 | 1 |
| ND | $597.60 | 1 |
| NE | $566.39 | 1 |
| NH | $634.09 | 1 |
| NJ | $671.28–$700.88 | 2 |
| NM | $600.06 | 1 |
| NV | $616.68 | 1 |
| NY | $591.13–$746.88 | 5 |
| OH | $590.06 | 1 |
| OK | $572.17 | 1 |
| OR | $609.04–$658.67 | 2 |
| PA | $589.25–$651.43 | 2 |
| PR | $627.22 | 1 |
| RI | $635.34 | 1 |
| SC | $587.43 | 1 |
| SD | $594.54 | 1 |
| TN | $567.90 | 1 |
| TX | $585.44–$641.58 | 8 |
| UT | $595.76 | 1 |
| VA | $604.11–$708.14 | 2 |
| VI | $627.22 | 1 |
| VT | $598.09 | 1 |
| WA | $636.25–$713.51 | 2 |
| WI | $576.96 | 1 |
| WV | $591.43 | 1 |
| WY | $612.22 | 1 |
How the 25565 rate is calculated
Each of 25565’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 · 25565
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.70Practice expense 11.66Malpractice 1.31
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25565
25565 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25565
Forearm fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25565
Forearm fracture care
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25565 without 50 · national office
$623.59
Forearm fracture care
25565-50 · Bilateral: 150%
$935.39
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).
25565 compared with similar codes
Compare codes
25565 vs 25560 vs 25505 vs 25535 vs 25575: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25560Forearm fracture care
- Use 25560 for closed treatment of both radius and ulna shaft fractures without manipulation. This code requires manipulation.
- 25505Fracture treatment
- 25505 is for a radial shaft fracture treated with manipulation; this code covers shaft fractures of both the radius and ulna.
- 25535Fracture treatment
- 25535 is for an ulnar shaft fracture treated with manipulation; this code covers both forearm bones.
- 25575Forearm fracture repair
- 25575 describes operative treatment with internal fixation of both shaft fractures. This code is for closed treatment with manipulation, without fixation.
25565 billing questions
How is this different from 25560?
25560 covers closed treatment of radius and ulna shaft fractures without manipulation. Use 25565 when the physician manipulates the fractures to restore alignment.
Can this code be used for a fracture of only one forearm bone?
No. It is for shaft fractures of both the radius and ulna treated with manipulation. A single-bone fracture requires the code for that bone and treatment method.
Is immobilization separately reported?
Immobilization is part of the closed fracture treatment. Do not separately report cast or splint application as a distinct service when it is included in the fracture care.
What documentation supports reporting 25565?
Document shaft fractures of both bones, the closed manipulation performed, and the resulting alignment and immobilization. Imaging findings can support the fracture diagnoses and reduction.
How does the global period affect follow-up visits?
The 90-day global period includes related postoperative care and the day-before preoperative visit. Routine follow-up for the treated fractures is included during that period.
Can an assistant or co-surgeon be billed for this procedure?
CMS restricts assistant-at-surgery payment for this code and does not permit co-surgeons or team surgery.
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
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