No office rate
25490 covers prophylactic treatment of the radius alone. Use 25492 when the operation prophylactically treats both the radius and ulna.
On this page
CMS RVU26D · Effective 2026-10-01
25492 Prophylactic fixation Medicare reimbursement rates in Delaware
Reports operative stabilization of both the radius and ulna when weakened bone is at risk of fracture, before a fracture has occurred. Compare 25492 office and facility rates across CMS payment localities in Delaware.
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 25492 in Delaware?
Delaware 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
$832.47
1 of 1 localities have a supported rate.
Payment area: Delaware
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 25492: Prophylactic stabilization of both forearm bones
Reports operative stabilization of both the radius and ulna when weakened bone is at risk of fracture, before a fracture has occurred.
An orthopedic surgeon stabilizes both forearm bones to reduce the risk of fracture in bone weakened by disease or another structural problem. The procedure may use fixation such as a nail or pins, with or without bone cement. It is performed in an operative setting when the clinical concern is an impending fracture, rather than repair of a fracture that has already occurred.
Report this code when the prophylactic operation treats both the radius and ulna. The operative report should identify the bones treated, the underlying risk of fracture, and the stabilization performed. CMS assigns 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. For bilateral services, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 25492
- 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 RVU12.34 · 49%
- Practice expense (office) RVU10.29 · 41%
- Malpractice RVU2.62 · 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.
25492 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
25491 covers prophylactic treatment of the ulna alone. Use 25492 when both forearm bones receive prophylactic treatment.
No office rate
25415 is for repair involving both the radius and ulna. 25492 is for prophylactic stabilization before a fracture has occurred.
No office rate
25400 is a repair code for the radius or ulna. 25492 applies when prophylactic treatment is performed on both bones.
Compare 25492 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
Delaware →
Office / nonfacility
Unavailable
Facility
$832.47
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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 25492 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,471
- Code
- 25492
- Physician work
- 12.34
- Practice expense
- 10.29
- Malpractice
- 2.62
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.34 | × 1.005 | 12.4017 |
| Practice expense | 10.29 | × 0.988 | 10.1665 |
| Malpractice | 2.62 | × 0.899 | 2.3554 |
| Total RVUs | 24.9236 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$832.47
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.34 | 1.005 |
| Practice expense | 10.29 | 0.988 |
| Malpractice | 2.62 | 0.899 |
(12.34 × 1.005 + 10.29 × 0.988 + 2.62 × 0.899) × $33.4009 = $832.47
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.
25492 billing questions
When is 25492 used instead of 25490 or 25491?
Use 25492 when prophylactic stabilization treats both the radius and ulna. Code 25490 is for the radius alone, and 25491 is for the ulna alone.
Can this code be reported for repair of an existing fracture?
This code describes prophylactic treatment to reduce fracture risk. When the operation repairs an existing fracture or fracture-related defect, consider the applicable repair code instead.
Are fixation and bone cement separately reported?
Nailing, pinning, and use of methylmethacrylate are described as techniques within the prophylactic treatment. The operative documentation should support the work performed on both bones.
How is bilateral treatment reported?
When the prophylactic procedure is performed on both forearms, report modifier 50 according to the CMS bilateral rule; payment is 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this procedure?
CMS permits assistant-at-surgery payment for this code. Co-surgeons and team surgery are 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 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.
2,46825455,,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
2,47425515,,Optx radial shaft fracture,A,,8.58,8.66,NA,8.66,,1.74,18.98,18.98,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503