No office rate
Use 25490 when prophylactic stabilization is performed on the radius. This code is specific to the ulna.
On this page
CMS RVU26D · Effective 2026-10-01
25491 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$695.84
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Orthopedic surgery
About 25491: Prophylactic ulna stabilization
Reports operative stabilization of an ulna weakened and at risk for fracture, such as from destructive bone disease, before a fracture occurs.
An orthopedic surgeon stabilizes the ulna before it breaks when disease or bone damage has made it vulnerable to fracture. The operation may use internal fixation such as a plate, pins, wires, or a nail; bone cement may also be used. A typical clinical setting is an operating room, with a destructive lesion, including one related to metastatic disease, creating concern for an impending fracture.
Choose this code when the operative goal is to prevent an ulna fracture, rather than to repair an existing fracture or a healing problem. The record should identify the ulna treated, the condition weakening the bone, the fracture risk, and the stabilization performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25491
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.90 · 48%
- Practice expense (office) RVU8.79 · 42%
- Malpractice RVU2.11 · 10%
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.
25491 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
Use 25492 when both radius and ulna receive prophylactic treatment; 25491 identifies treatment of the ulna alone.
No office rate
25400 describes repair of an established radius or ulna healing problem. Choose 25491 when the operation is intended to prevent a fracture.
No office rate
25405 is for repair of a radius or ulna healing problem with grafting, not prophylactic stabilization of an at-risk ulna.
The same code, a different location
How does Merced compare?
25491 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Modesto
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Napa
California · 25491
Office
Unavailable
Facility
$774.26
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 25491
Office
Unavailable
Facility
$730.86
No comparable office rate is available.
Redding
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Rest Of California
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 25491
Office
Unavailable
Facility
$718.52
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 25491
Office
Unavailable
Facility
$721.80
No comparable office rate is available.
Salinas
California · 25491
Office
Unavailable
Facility
$718.97
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 25491
Office
Unavailable
Facility
$729.93
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 25491
Office
Unavailable
Facility
$808.40
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 25491
Office
Unavailable
Facility
$806.00
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 25491
Office
Unavailable
Facility
$828.18
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 25491
Office
Unavailable
Facility
$818.38
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 25491
Office
Unavailable
Facility
$708.47
No comparable office rate is available.
Santa Cruz-Watsonville
California · 25491
Office
Unavailable
Facility
$732.10
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 25491
Office
Unavailable
Facility
$720.03
No comparable office rate is available.
Santa Rosa-Petaluma
California · 25491
Office
Unavailable
Facility
$738.90
No comparable office rate is available.
Stockton
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Vallejo
California · 25491
Office
Unavailable
Facility
$770.81
No comparable office rate is available.
Visalia
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Yuba City
California · 25491
Office
Unavailable
Facility
$695.84
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 25491
Office
Unavailable
Facility
$772.82
No comparable office rate is available.
Miami
Florida · 25491
Office
Unavailable
Facility
$814.53
No comparable office rate is available.
Chicago
Illinois · 25491
Office
Unavailable
Facility
$789.79
No comparable office rate is available.
Manhattan
New York · 25491
Office
Unavailable
Facility
$804.76
No comparable office rate is available.
Alaska*
Alaska · 25491
Office
Unavailable
Facility
$847.51
No comparable office rate is available.
Alabama
Alabama · 25491
Office
Unavailable
Facility
$627.45
No comparable office rate is available.
Arkansas
Arkansas · 25491
Office
Unavailable
Facility
$619.16
No comparable office rate is available.
Arizona
Arizona · 25491
Office
Unavailable
Facility
$675.49
No comparable office rate is available.
Colorado
Colorado · 25491
Office
Unavailable
Facility
$702.06
No comparable office rate is available.
Connecticut
Connecticut · 25491
Office
Unavailable
Facility
$738.76
No comparable office rate is available.
Delaware
Delaware · 25491
Office
Unavailable
Facility
$685.75
No comparable office rate is available.
Fort Lauderdale
Florida · 25491
Office
Unavailable
Facility
$755.50
No comparable office rate is available.
Rest Of Florida
Florida · 25491
Office
Unavailable
Facility
$717.27
No comparable office rate is available.
Atlanta
Georgia · 25491
Office
Unavailable
Facility
$714.59
No comparable office rate is available.
Rest Of Georgia
Georgia · 25491
Office
Unavailable
Facility
$676.56
No comparable office rate is available.
Hawaii, Guam
Hawaii · 25491
Office
Unavailable
Facility
$705.29
No comparable office rate is available.
Iowa
Iowa · 25491
Office
Unavailable
Facility
$627.29
No comparable office rate is available.
Idaho
Idaho · 25491
Office
Unavailable
Facility
$634.11
No comparable office rate is available.
East St. Louis
Illinois · 25491
Office
Unavailable
Facility
$742.71
No comparable office rate is available.
Rest Of Illinois
Illinois · 25491
Office
Unavailable
Facility
$708.87
No comparable office rate is available.
Suburban Chicago
Illinois · 25491
Office
Unavailable
Facility
$759.39
No comparable office rate is available.
Indiana
Indiana · 25491
Office
Unavailable
Facility
$637.08
No comparable office rate is available.
Kansas
Kansas · 25491
Office
Unavailable
Facility
$631.60
No comparable office rate is available.
Kentucky
Kentucky · 25491
Office
Unavailable
Facility
$656.16
No comparable office rate is available.
New Orleans
Louisiana · 25491
Office
Unavailable
Facility
$687.00
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 25491
Office
Unavailable
Facility
$658.02
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 25491
Office
Unavailable
Facility
$757.50
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 25491
Office
Unavailable
Facility
$701.28
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 25491
Office
Unavailable
Facility
$738.16
No comparable office rate is available.
Rest Of Maryland
Maryland · 25491
Office
Unavailable
Facility
$695.79
No comparable office rate is available.
Rest Of Maine
Maine · 25491
Office
Unavailable
Facility
$644.61
No comparable office rate is available.
Southern Maine
Maine · 25491
Office
Unavailable
Facility
$666.09
No comparable office rate is available.
Detroit
Michigan · 25491
Office
Unavailable
Facility
$732.81
No comparable office rate is available.
Rest Of Michigan
Michigan · 25491
Office
Unavailable
Facility
$678.29
No comparable office rate is available.
Minnesota
Minnesota · 25491
Office
Unavailable
Facility
$653.64
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 25491
Office
Unavailable
Facility
$675.21
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 25491
Office
Unavailable
Facility
$680.79
No comparable office rate is available.
Rest Of Missouri
Missouri · 25491
Office
Unavailable
Facility
$652.39
No comparable office rate is available.
Mississippi
Mississippi · 25491
Office
Unavailable
Facility
$635.53
No comparable office rate is available.
Montana**
Montana · 25491
Office
Unavailable
Facility
$694.60
No comparable office rate is available.
North Carolina
North Carolina · 25491
Office
Unavailable
Facility
$649.63
No comparable office rate is available.
North Dakota**
North Dakota · 25491
Office
Unavailable
Facility
$652.88
No comparable office rate is available.
Nebraska
Nebraska · 25491
Office
Unavailable
Facility
$628.30
No comparable office rate is available.
New Hampshire
New Hampshire · 25491
Office
Unavailable
Facility
$697.97
No comparable office rate is available.
Northern Nj
New Jersey · 25491
Office
Unavailable
Facility
$767.34
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 25491
Office
Unavailable
Facility
$741.81
No comparable office rate is available.
New Mexico
New Mexico · 25491
Office
Unavailable
Facility
$684.54
No comparable office rate is available.
Nevada**
Nevada · 25491
Office
Unavailable
Facility
$683.26
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 25491
Office
Unavailable
Facility
$831.79
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 25491
Office
Unavailable
Facility
$752.31
No comparable office rate is available.
Queens
New York · 25491
Office
Unavailable
Facility
$800.49
No comparable office rate is available.
Rest Of New York
New York · 25491
Office
Unavailable
Facility
$659.13
No comparable office rate is available.
Ohio
Ohio · 25491
Office
Unavailable
Facility
$669.76
No comparable office rate is available.
Oklahoma
Oklahoma · 25491
Office
Unavailable
Facility
$647.61
No comparable office rate is available.
Portland
Oregon · 25491
Office
Unavailable
Facility
$714.58
No comparable office rate is available.
Rest Of Oregon
Oregon · 25491
Office
Unavailable
Facility
$672.63
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 25491
Office
Unavailable
Facility
$726.33
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 25491
Office
Unavailable
Facility
$666.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 25491
Office
Unavailable
Facility
$696.91
No comparable office rate is available.
Rhode Island
Rhode Island · 25491
Office
Unavailable
Facility
$703.10
No comparable office rate is available.
South Carolina
South Carolina · 25491
Office
Unavailable
Facility
$661.85
No comparable office rate is available.
South Dakota**
South Dakota · 25491
Office
Unavailable
Facility
$647.94
No comparable office rate is available.
Tennessee
Tennessee · 25491
Office
Unavailable
Facility
$635.39
No comparable office rate is available.
Austin
Texas · 25491
Office
Unavailable
Facility
$704.39
No comparable office rate is available.
Beaumont
Texas · 25491
Office
Unavailable
Facility
$663.31
No comparable office rate is available.
Brazoria
Texas · 25491
Office
Unavailable
Facility
$679.24
No comparable office rate is available.
Dallas
Texas · 25491
Office
Unavailable
Facility
$686.53
No comparable office rate is available.
Fort Worth
Texas · 25491
Office
Unavailable
Facility
$684.51
No comparable office rate is available.
Galveston
Texas · 25491
Office
Unavailable
Facility
$683.21
No comparable office rate is available.
Houston
Texas · 25491
Office
Unavailable
Facility
$721.83
No comparable office rate is available.
Rest Of Texas
Texas · 25491
Office
Unavailable
Facility
$672.93
No comparable office rate is available.
Utah
Utah · 25491
Office
Unavailable
Facility
$669.93
No comparable office rate is available.
Virginia
Virginia · 25491
Office
Unavailable
Facility
$669.03
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 25491
Office
Unavailable
Facility
$696.91
No comparable office rate is available.
Vermont
Vermont · 25491
Office
Unavailable
Facility
$656.99
No comparable office rate is available.
Rest Of Washington
Washington · 25491
Office
Unavailable
Facility
$697.75
No comparable office rate is available.
Seattle (King Cnty)
Washington · 25491
Office
Unavailable
Facility
$765.02
No comparable office rate is available.
Wisconsin
Wisconsin · 25491
Office
Unavailable
Facility
$633.64
No comparable office rate is available.
West Virginia
West Virginia · 25491
Office
Unavailable
Facility
$686.65
No comparable office rate is available.
Wyoming**
Wyoming · 25491
Office
Unavailable
Facility
$676.41
No comparable office rate is available.
See how rates vary across the country
25491 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 25491 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$765.42
$695.84 × 110% = $765.42
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 25491 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,470
- Code
- 25491
- Physician work
- 9.90
- Practice expense
- 8.79
- Malpractice
- 2.11
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.90 | × 1.017 | 10.0683 |
| Practice expense | 8.79 | × 1.096 | 9.6338 |
| Malpractice | 2.11 | × 0.536 | 1.1310 |
| Total RVUs | 20.8331 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$695.84
Open 25491 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.9 | 1.017 |
| Practice expense | 8.79 | 1.096 |
| Malpractice | 2.11 | 0.536 |
(9.9 × 1.017 + 8.79 × 1.096 + 2.11 × 0.536) × $33.4009 = $695.84
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
25491 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $695.84 | RVU26D |
| 2026-07-01 | Not available in this setting | $695.84 | RVU26C |
| 2026-04-01 | Not available in this setting | $695.84 | RVU26B |
| 2026-01-01 | Not available in this setting | $695.84 | RVU26A |
| 2025-10-01 | Not available in this setting | $740.94 | RVU25D |
| 2025-07-01 | Not available in this setting | $740.94 | RVU25C |
| 2025-04-01 | Not available in this setting | $740.94 | RVU25B |
| 2025-01-01 | Not available in this setting | $740.94 | RVU25A |
25491 billing questions
How does 25491 differ from 25490 and 25492?
25491 is for prophylactic stabilization of the ulna. Code 25490 is for the radius, while 25492 covers both the radius and ulna.
Can 25491 be used when the ulna is already fractured?
This code describes stabilization intended to prevent a fracture. When surgery repairs an established fracture or a nonunion, select the code that describes that repair instead.
What documentation supports reporting 25491?
Document the affected ulna, the bone-weakening condition, why fracture prevention is needed, and the fixation or other stabilization performed.
Does the 90-day global period include postoperative care?
Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported with 25491?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted under the CMS rules 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,46725450,,Epiphysl arrst dstl rds/ulna,A,,7.86,8.14,NA,8.14,,1.67,17.67,17.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46825455,,Epiphysl arrst dstl rds&ulna,A,,9.47,9.21,NA,9.21,,2.02,20.70,20.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46925490,,Prophylactic tx radius,A,,9.49,8.81,NA,8.81,,2.02,20.32,20.32,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47025491,,Prophylactic tx ulna,A,,9.90,8.79,NA,8.79,,2.11,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47125492,,Prophylactic tx radius&ulna,A,,12.34,10.29,NA,10.29,,2.62,25.25,25.25,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47225500,,Cltx rdl shft fx w/o mnpj,A,,2.54,6.73,,5.12,,0.51,9.78,8.17,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47325505,,Cltx rdl shft fx w/mnpj,A,,5.31,11.16,,8.18,,1.20,17.67,14.69,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623