Billing code 25565: Forearm fracture careMedicare rate & RVUs in Alaska

Reports closed manipulation and treatment of shaft fractures of both the radius and ulna, such as a displaced both-bone forearm fracture.

CMS RVU26DEffective Oct 1, 20261 payment locality453 Medicare services in 2024

Medicare pays $724.46 for 25565 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$724.46Office (non-facility)
$603.16Hospital or facility

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

We’ll open 25565 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 25565 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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.

25565 in Alaska*

25565 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$724.46$603.16

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

Work5.70

5.70 RVUs× 1.000 GPCI

Practice expense11.66

11.66 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

18.6700

Conversion factor

$33.4009

Medicare rate

$623.59

Every GPCI starts 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

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)1Not paid (statutory restriction).
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 · 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

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).

When to use modifier 50

25565 compared with similar codes

Compare codes · National

5 codes, side by side

  • 25565

    Forearm fracture care5.7 wRVU

    $623.59

  • 25560

    Forearm fracture care2.53 wRVU

    $332.00−$291.59

  • 25505

    Fracture treatment5.31 wRVU

    $590.19−$33.40

  • 25535

    Fracture treatment5.23 wRVU

    $548.11−$75.48

  • 25575

    Forearm fracture repair11.98 wRVU

    Not priced

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
RVUs for 25565PPRRVU2026_Oct_nonQPP.csv, line 2,482 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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