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Billing code 25909: Amputation revisionMedicare rate & RVUs

Reports operative revision of a forearm amputation stump when a prior amputation requires further surgery at the residual-limb level.

CMS RVU26DEffective Oct 1, 2026109 payment localities19 Medicare services in 2024

Medicare pays $645.97 for 25909 nationally in a facility.

Medicare rate · 25909

Amputation revision

Swap in your local Medicare rate.

Work RVUs
9.08
Total RVUs
19.34
Global days
090

National rate · 2026

$645.97

Facility setting, before claim adjustments.

See every locality for 25909 → · 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 25909 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 25909 covers

This code covers further surgery on a previously amputated forearm, rather than the initial removal of the forearm. A hand or upper-extremity surgeon may revise the residual limb when the stump needs operative correction, such as for a problematic scar, wound, or bony contour. The service is typically performed in a hospital or ambulatory surgical setting; the operative report should establish the prior amputation and the revision performed.

Report the code when the documented procedure meets its specific billing code definition, not merely because the patient has a prior amputation. CMS assigns a 90-day global period: the day-before preoperative visit and related care during the following 90 days are included. If multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays 150%. An assistant at surgery may be paid; 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 25909 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

25909 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$583.22
Alaska*Unavailable$786.75
ArizonaUnavailable$628.07
ArkansasUnavailable$575.48
AtlantaUnavailable$664.29
AustinUnavailable$655.37
BakersfieldUnavailable$653.24
Baltimore/Surr. CntysUnavailable$686.41
BeaumontUnavailable$616.36
BrazoriaUnavailable$631.71

25909 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
25909 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 25909 rate is calculated

Each of 25909’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 · 25909

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.08Practice expense 8.33Malpractice 1.93

19.3400 adjusted RVUs×$33.4009 conversion factor=$645.97

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

Payment rules and modifiers for 25909

25909 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25909

Amputation revision

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)0Not permitted.
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 · 25909

Amputation revision

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

25909 without 50 · national facility

$645.97

Amputation revision

25909-50 · Bilateral: 150%

$968.96

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

25909 compared with similar codes

Compare codes

25909 vs 25900 vs 25907 vs 25924: national Medicare rates

Swap in your local Medicare rate.

  • 25909
    Amputation revision · 9.08 wRVU
    —
  • 25900
    Forearm amputation · 9.37 wRVU
    —
  • 25907
    Amputation revision · 7.89 wRVU
    —
  • 25924
    Amputation revision · 8.59 wRVU
    —

How to choose

25900Forearm amputation
Use 25900 for the initial forearm amputation through the radius and ulna. Use 25909 for a qualifying revision of a prior forearm amputation.
25907Amputation revision
Both relate to forearm amputation revision. Choose based on the operative criteria in the code descriptors and the work documented, not the general label of stump revision.
25924Amputation revision
25924 concerns revision at the wrist level. This code concerns revision at the forearm level; the documented anatomic site guides selection.

Codes related to 25909

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

Codes related to 25909
CodeHow it relatesNational office range
Same family
25907Amputation revisionAnother forearm amputation revision code; select according to the specific operative criteria.No office rate
25900Forearm amputationDescribes primary forearm amputation rather than revision of an existing stump.No office rate
25905Forearm amputationA forearm amputation code for an initial procedure, not a general substitute for stump revision.No office rate
Used instead
25924Amputation revisionRevision code for a wrist-level amputation; the anatomic level distinguishes it from forearm revision.No office rate

25909 billing questions

How is this different from a primary forearm amputation?

This code is for surgery on an existing forearm amputation stump. A code for primary forearm amputation describes the initial removal, not subsequent stump revision.

How should I distinguish this from 25907?

Both codes concern forearm amputation revision. Apply the specific operative criteria in the billing code descriptors; the fact that a stump was revised by itself does not establish which code applies.

Are routine postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit. The global period does not include unrelated services.

Can I report modifier 50 for bilateral revisions?

Yes. CMS treats this as a bilateral procedure and pays 150% when reported bilaterally with modifier 50.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.

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 25909PPRRVU2026_Oct_nonQPP.csv, line 2,518 (RVU26D)

Open CMS sourceHow we calculate rates

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