Billing code 25535: Fracture treatmentMedicare rate & RVUs in Georgia
Reports closed reduction of an ulnar shaft fracture when the physician manipulates the bone to improve alignment without open surgery.
Medicare pays $518.60–$561.28 for 25535 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.
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 25535 covers
An orthopedic surgeon or other qualified physician reports this service for closed treatment of an ulnar shaft fracture that requires manipulation to restore alignment. The reduction is performed without surgically exposing the fracture; immobilization may follow. Typical settings include an emergency department, clinic, or hospital, depending on where the fracture is treated.
Select this code when documentation supports manipulation of the ulnar shaft fracture, rather than treatment without manipulation or open fixation. Record the fracture site, reduction performed, and treatment plan. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services are not paid; 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.
Where 25535 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $561.28 | $464.90 |
| Rest Of Georgia | $518.60 | $433.99 |
How the 25535 rate is calculated
Each of 25535’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 · 25535
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.23Practice expense 10.10Malpractice 1.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25535
25535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25535
Fracture treatment
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 25535
Fracture treatment
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
25535 without 50 · national office
$548.11
Fracture treatment
25535-50 · Bilateral: 150%
$822.17
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).
25535 compared with similar codes
Compare codes
25535 vs 25530 vs 25545 vs 25505 vs 25565: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25530Fracture treatment
- Both describe closed treatment of an ulnar shaft fracture. Choose 25535 when manipulation is performed; choose 25530 when it is not.
- 25545Fracture fixation
- 25545 describes open treatment with internal fixation. This code is for closed reduction by manipulation without open fixation.
- 25505Fracture treatment
- 25505 applies to a radial shaft fracture treated closed with manipulation; 25535 applies to the ulnar shaft.
- 25565Forearm fracture care
- 25565 describes closed treatment with manipulation of fractures involving both the radial and ulnar shafts, rather than an ulnar shaft fracture alone.
25535 billing questions
How does this differ from 25530?
Use 25535 when the physician manipulates the ulnar shaft fracture to improve alignment. Code 25530 describes closed treatment without manipulation.
When is 25545 more appropriate?
Code 25545 is for open treatment of an ulnar shaft fracture with internal fixation. This code describes closed treatment with manipulation, without open fixation.
What documentation supports reporting 25535?
Document the ulnar shaft fracture, the manipulation or reduction performed, and the treatment plan. The record should distinguish the service from treatment without manipulation.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS applies that period to this fracture treatment.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How are bilateral treatment and multiple procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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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