Billing code 25400: Forearm bone repairMedicare rate & RVUs in Florida
Reports operative repair of a radius or ulna fracture nonunion or malunion when one forearm bone is treated without a graft.
CMS doesn’t publish an office rate for 25400 in Florida.
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 25400 covers
This operation treats a radius or ulna fracture that has failed to unite or has healed in a position requiring correction. An orthopedic surgeon works on the affected forearm bone to address the nonunion or malalignment and restore stability. The service is typically performed in an operating room, including a hospital outpatient department or inpatient setting, rather than as routine fracture follow-up.
Report this code when the repair involves one bone and is performed without a graft; use the applicable family code when both bones or grafting are involved. The operative report should identify the bone, the nonunion or malunion being treated, and the repair performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.
Where 25400 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $799.32 |
| Miami | Unavailable | $859.67 |
| Rest Of Florida | Unavailable | $760.35 |
How the 25400 rate is calculated
Each of 25400’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 · 25400
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.00Practice expense 8.91Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25400
25400 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25400
Forearm bone repair
| 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 · 25400
Forearm bone repair
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
25400 without 50 · national facility
$737.16
Forearm bone repair
25400-50 · Bilateral: 150%
$1,105.74
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).
25400 compared with similar codes
Compare codes
25400 vs 25405 vs 25415 vs 25420: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25405Forearm bone repair
- Both codes address a nonunion or malunion of one radius or ulna; 25405 is the grafted repair, while 25400 is for repair without a graft.
- 25415Forearm bone repair
- Use 25415 when the repair involves both the radius and ulna without graft, rather than a single forearm bone.
- 25420Forearm repair
- 25420 covers grafted repair involving both the radius and ulna; 25400 is for one bone without graft.
25400 billing questions
When is 25400 appropriate instead of 25405?
Use 25400 for a one-bone radius or ulna repair without a graft. The grafted one-bone repair is represented by 25405.
Can 25400 be reported for both the radius and ulna?
When both forearm bones are repaired, the family includes codes for repair of the radius and ulna together. Do not use 25400 twice to represent that service.
What documentation supports 25400?
Document which bone is repaired, the nonunion or malunion being treated, and the operative work performed. The record should also support that the repair is without a graft.
How does the bilateral payment rule affect reporting?
For bilateral performance, report modifier 50; CMS lists payment at 150%. The operative documentation should support repair on both sides.
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 in that session are paid at 50%.
Is an assistant or co-surgeon reportable for this operation?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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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