No office rate
Choose 25400 for a one-bone repair without graft; 25405 includes the patient's own bone graft.
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CMS RVU26D · Effective 2026-10-01
25405 Forearm bone repair Medicare reimbursement rates in Colorado
Corrects a radius or ulna nonunion or malunion using the patient's own bone graft to support healing of the repaired forearm bone. Compare 25405 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 25405 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$946.81
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 25405: Single-bone forearm nonunion repair with autograft
Corrects a radius or ulna nonunion or malunion using the patient's own bone graft to support healing of the repaired forearm bone.
This operation treats a radius or ulna that has failed to heal or has healed in a problematic position. The orthopedic or hand surgeon exposes the affected bone, corrects its alignment or prepares the nonunion, adds bone graft taken from the patient, and stabilizes the repair. It is generally performed in an operating room, often in a hospital or ambulatory surgery setting.
Report this code when one forearm bone is repaired with autograft; the graft harvest is included. Document which bone and side were treated, the nonunion or malunion, and the use of the patient's own graft. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies bilateral work and is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25405
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.63 · 52%
- Practice expense (office) RVU10.62 · 38%
- Malpractice RVU2.87 · 10%
546
Medicare services in 2024 · #3477 by national volume
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.
25405 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
25420 is for repair of both the radius and ulna with autograft. 25405 is for one of those bones.
No office rate
Both codes address a single-bone forearm repair with graft, but 25425 uses allograft rather than the patient's own bone.
Compare 25405 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$946.81
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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 25405 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,450
- Code
- 25405
- Physician work
- 14.63
- Practice expense
- 10.62
- Malpractice
- 2.87
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.63 | × 1.012 | 14.8056 |
| Practice expense | 10.62 | × 1.064 | 11.2997 |
| Malpractice | 2.87 | × 0.781 | 2.2415 |
| Total RVUs | 28.3467 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$946.81
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.63 | 1.012 |
| Practice expense | 10.62 | 1.064 |
| Malpractice | 2.87 | 0.781 |
(14.63 × 1.012 + 10.62 × 1.064 + 2.87 × 0.781) × $33.4009 = $946.81
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.
25405 billing questions
How does 25405 differ from 25400?
25405 applies when the repair uses the patient's own bone graft. Use 25400 for the corresponding single-bone repair without graft.
Can the graft harvest be billed separately?
No. Obtaining the autograft is included in this repair.
Does 25405 cover repair of both forearm bones?
No. It covers the radius or the ulna. For repair of both bones with autograft, compare 25420.
When is modifier 50 appropriate?
Use modifier 50 when the repair is performed bilaterally. CMS pays the bilateral procedure at 150%.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,44725393,,Lengthen radius & ulna,A,,16.15,11.34,NA,11.34,,3.44,30.93,30.93,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44825394,,Repair carpal bone shorten,A,,10.58,9.19,NA,9.19,,2.25,22.02,22.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44925400,,Repair radius or ulna,A,,11.00,8.91,NA,8.91,,2.16,22.07,22.07,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45025405,,Repair/graft radius or ulna,A,,14.63,10.62,NA,10.62,,2.87,28.12,28.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45125415,,Repair radius & ulna,A,,13.46,10.48,NA,10.48,,2.87,26.81,26.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45225420,,Repair/graft radius & ulna,A,,16.61,11.84,NA,11.84,,3.54,31.99,31.99,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45325425,,Repair/graft radius or ulna,A,,13.38,10.45,NA,10.45,,2.85,26.68,26.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899