Billing code 25609: Distal radius fixationMedicare rate & RVUs in Georgia
Report 25609 for open reduction and fixation of a distal radius fracture involving the joint surface with three or more fragments.
CMS doesn’t publish an office rate for 25609 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 25609 covers
This service involves surgically exposing a distal radius fracture, restoring alignment of the joint surface, and stabilizing the fracture with fixation. It is typically performed by an orthopedic or hand surgeon for a complex, comminuted fracture that extends into the wrist joint. The procedure is commonly performed in a hospital operating room or ambulatory surgery center.
Choose this code when the fracture is intra-articular and has three or more fragments; the operative report should establish joint involvement, fragment count, open treatment, and fixation performed. Reduction and fixation are part of the service, not separate procedures. CMS assigns a 90-day global period that 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 25609 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $994.69 |
| Rest Of Georgia | Unavailable | $941.85 |
How the 25609 rate is calculated
Each of 25609’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 · 25609
RVUs × geographic indexes × conversion factor
Work14.02
14.02 RVUs× 1.000 GPCI
Practice expense12.22
12.22 RVUs× 1.000 GPCI
Malpractice2.75
2.75 RVUs× 1.000 GPCI
Adjusted RVUs
28.9900
Conversion factor
$33.4009
Medicare rate
$968.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25609
25609 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25609
Distal radius fixation
| 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) | 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 · 25609
Distal radius fixation
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
25609 without 50 · national facility
$968.29
Distal radius fixation
25609-50 · Bilateral: 150%
$1,452.44
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).
25609 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 25608Distal radius repair
- Both are open fixation codes for intra-articular distal radius fractures. The fragment count distinguishes them: 25608 is for two fragments, while 25609 is for three or more.
- 25607Distal radius repair
- 25607 applies to an extra-articular distal radius fracture treated openly. Use 25609 for an intra-articular fracture with three or more fragments.
- 25606Distal radius fixation
- 25606 describes percutaneous skeletal fixation of a distal radius fracture. 25609 describes open treatment of an intra-articular fracture with three or more fragments.
- 25605Wrist fracture treatment
- 25605 is closed treatment with manipulation, rather than open reduction and fixation. Choose based on the treatment actually performed.
25609 billing questions
How is 25609 different from 25608?
Both describe open treatment of an intra-articular distal radius fracture with fixation. Use 25609 when there are three or more fragments; 25608 is for two fragments.
When should 25607 be reported instead?
25607 is for open treatment of an extra-articular distal radius fracture. The fracture treated with 25609 must extend into the wrist joint and involve three or more fragments.
Can reduction or fixation be billed separately?
No. The open reduction and fixation are included in 25609; document the fracture pattern and operative work supporting the code.
What documentation supports 25609?
The operative report should identify intra-articular extension, establish that three or more fragments are involved, and describe the open treatment and fixation.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral procedures or other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and 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
Fee sheets
Put 25609 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →