Billing code 25450: Physeal arrestMedicare rate & RVUs in Alaska
Surgical growth-plate arrest of one distal forearm bone is reported to manage a growth-related wrist deformity or length discrepancy.
CMS doesn’t publish an office rate for 25450 in Alaska.
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 9 sections
What 25450 covers
An orthopedic surgeon performs this operation to stop growth at the distal growth plate of either the radius or the ulna. It may be considered when continued growth is expected to worsen a wrist or forearm deformity or contribute to a limb-length discrepancy. The operative report should identify the bone and side treated and describe the growth-related problem and the procedure performed.
Report 25450 for one bone; when both the distal radius and ulna are treated on the same side, use 25455. For the same procedure on both sides, CMS recognizes modifier 50 and pays at 150%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures at 50%. CMS does not pay an assistant at surgery for this code; 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.
25450 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $714.09 |
How the 25450 rate is calculated
Each of 25450’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 · 25450
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.86Practice expense 8.14Malpractice 1.67
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25450
25450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25450
Physeal arrest
| 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 · 25450
Physeal arrest
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
25450 without 50 · national facility
$590.19
Physeal arrest
25450-50 · Bilateral: 150%
$885.29
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).
25450 compared with similar codes
Compare codes
25450 vs 25455 vs 25400 vs 25405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25455Growth arrest
- Choose 25455 when the distal radius and ulna are both treated on the same side; 25450 covers either bone alone.
- 25400Forearm bone repair
- 25400 describes repair of a radius or ulna nonunion or malunion, not arrest of growth at a distal physis.
- 25405Forearm bone repair
- 25405 is a radius or ulna repair involving grafting; 25450 addresses growth arrest rather than bone repair.
25450 billing questions
When should 25450 be reported instead of 25455?
Use 25450 when the procedure arrests growth in either the distal radius or the distal ulna. Use 25455 when both bones are treated on the same side.
How should the procedure be reported when both sides are treated?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the bone or bones treated and the side of each procedure.
Does the global period include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 25450?
Document the growth-related indication, the specific distal forearm bone and side treated, and the operative work performed. The record should make clear that one bone, rather than both distal bones on that side, was treated.
How is 25450 paid when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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