Billing code 25391: Bone lengtheningMedicare rate & RVUs in Delaware
Reports an operation to lengthen a shortened radius or ulna, typically to address a forearm bone-length discrepancy or deformity.
CMS doesn’t publish an office rate for 25391 in Delaware.
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 25391 covers
The surgeon makes a corrective cut in one forearm bone and lengthens it to address shortening or a resulting alignment problem. Orthopedic and hand surgeons may perform this operation for a growth-related difference, congenital shortening, or a post-traumatic deformity. It is generally performed in an operating room, often in a hospital or ambulatory surgery setting; the operative report should identify the bone treated and the lengthening performed.
Report 25391 when the procedure lengthens either the radius or the ulna, rather than both bones. Documentation should support the indication, the specific bone, and the operative work; lengthening both bones is represented by a different code. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral payment is 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
25391 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $907.24 |
How the 25391 rate is calculated
Each of 25391’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 · 25391
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.92Practice expense 10.63Malpractice 2.97
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25391
25391 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25391
Bone lengthening
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 25391
Bone lengthening
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
25391 without 50 · national facility
$919.19
Bone lengthening
25391-50 · Bilateral: 150%
$1,378.79
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).
25391 compared with similar codes
Compare codes
25391 vs 25390 vs 25392 vs 25393: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25390Bone shortening
- 25390 describes shortening one forearm bone; 25391 describes lengthening one. Select based on the direction of the change documented in the operation.
- 25392Forearm osteotomy
- 25392 is for shortening both the radius and ulna. It is not the one-bone lengthening service represented by 25391.
- 25393Forearm lengthening
- 25393 describes lengthening both forearm bones, while 25391 describes lengthening either the radius or the ulna.
25391 billing questions
When should 25391 be chosen over 25393?
Use 25391 when the surgeon lengthens one forearm bone, either the radius or ulna. Use 25393 when both bones are lengthened.
How does 25391 differ from 25390?
Both describe work on one forearm bone, but 25391 lengthens it and 25390 shortens it. The operative report should make the direction of the bone-length change clear.
Are related 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 begins with the operation.
How is bilateral performance handled?
The CMS bilateral rule specifies modifier 50 and payment at 150%. Documentation should identify the procedures performed on each side.
What documentation supports reporting 25391?
The operative report should identify whether the radius or ulna was lengthened and describe the corrective work. If both bones were lengthened, consider the code for lengthening both rather than 25391.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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