Billing code 25575: Forearm fracture repairMedicare rate & RVUs in Georgia
Reports open operative treatment of shaft fractures of both forearm bones, the radius and ulna, with internal fixation when performed.
CMS doesn’t publish an office rate for 25575 in Georgia.
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 25575 covers
This code describes open operative treatment of fractures involving the shafts of both the radius and ulna in the same forearm. An orthopedic surgeon typically exposes and aligns the fractures and may stabilize them with plates, screws, or other fixation. The service is generally performed in a hospital operating room or ambulatory surgery setting. The operative report should establish that both shaft fractures were treated through an open approach; treatment of only one bone points to a different code.
Report one unit for the treated radius-and-ulna fracture pair. Documentation should identify the bones and fracture sites and describe the open treatment and any fixation performed. The service has 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 other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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 25575 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $869.36 |
| Rest Of Georgia | Unavailable | $822.44 |
How the 25575 rate is calculated
Each of 25575’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 · 25575
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.98Practice expense 10.86Malpractice 2.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25575
25575 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25575
Forearm fracture 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 · 25575
Forearm fracture 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
25575 without 50 · national facility
$845.71
Forearm fracture repair
25575-50 · Bilateral: 150%
$1,268.57
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).
25575 compared with similar codes
Compare codes
25575 vs 25574 vs 25515 vs 25565: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25574Forearm fracture repair
- Both codes concern open treatment of radius-and-ulna shaft fractures. Choose 25575 when both bones are treated; 25574 is for treatment involving the radius or ulna.
- 25515Radius fracture repair
- 25515 is for open treatment of a radial shaft fracture alone. Use 25575 when the ulna shaft fracture is also treated.
- 25565Forearm fracture care
- 25565 describes closed treatment of both shaft fractures with manipulation. 25575 describes open operative treatment of both.
25575 billing questions
When should 25575 be chosen over 25574?
Use 25575 when open treatment addresses both the radius and ulna shaft fractures. Code 25574 applies when the open treatment is for the radius or ulna, rather than both.
Can 25575 be reported when only one forearm bone is treated?
No. When open treatment is limited to one shaft fracture, consider the code for that bone, such as 25515 for the radial shaft or 25545 for the ulnar shaft.
How does closed treatment differ from 25575?
25575 describes open operative treatment of both shaft fractures. Codes 25560 and 25565 describe closed treatment of both bones, without manipulation and with manipulation, respectively.
Does the 90-day global period include related postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other same-session procedures and bilateral cases handled?
For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral performance with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. 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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