No office rate
Choose 25316 for reconstruction involving multiple tendons for hand paralysis; 25315 is the single-tendon sibling.
On this page
CMS RVU26D · Effective 2026-10-01
25316 Hand tendon reconstruction Medicare reimbursement rates in Guam
Report this service for surgical reconstruction of multiple hand tendons to address paralysis-related loss of active hand function. Compare 25316 office and facility rates across CMS payment localities in Guam.
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 25316 in Guam?
Guam 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
$859.76
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Hand surgery
About 25316: Multiple tendon reconstruction for hand paralysis
Report this service for surgical reconstruction of multiple hand tendons to address paralysis-related loss of active hand function.
A hand or orthopedic surgeon reconstructs multiple tendons to improve active hand function when paralysis has disrupted tendon-driven movement. The operation may redirect or otherwise reconstruct functioning tendons to help restore tasks such as opening the hand or grasping. A typical setting is an operating room, with the operative plan tailored to the pattern of paralysis and the movements that remain possible.
Select this code when the documented operation addresses multiple tendons for hand paralysis; use the single-tendon sibling when only one tendon is reconstructed. The operative report should identify the paralysis, tendons treated, reconstructive work performed, and functional goal. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons and team surgery are not permitted.
CMS billing rules for 25316
- 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 RVU12.58 · 49%
- Practice expense (office) RVU10.21 · 40%
- Malpractice RVU2.68 · 11%
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.
25316 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
25310 describes tendon transplantation in the forearm or wrist. Use 25316 when the operation is multiple-tendon reconstruction of a paralyzed hand.
No office rate
25312 represents a forearm or wrist tendon transplant. 25316 is the more specific fit for multiple-tendon reconstruction addressing hand paralysis.
Compare 25316 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$859.76
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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 25316 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,433
- Code
- 25316
- Physician work
- 12.58
- Practice expense
- 10.21
- Malpractice
- 2.68
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.58 | × 1.000 | 12.5800 |
| Practice expense | 10.21 | × 1.137 | 11.6088 |
| Malpractice | 2.68 | × 0.579 | 1.5517 |
| Total RVUs | 25.7405 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$859.76
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.58 | 1 |
| Practice expense | 10.21 | 1.137 |
| Malpractice | 2.68 | 0.579 |
(12.58 × 1 + 10.21 × 1.137 + 2.68 × 0.579) × $33.4009 = $859.76
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.
25316 billing questions
How does this differ from 25315?
25316 is for reconstruction involving multiple tendons for hand paralysis. 25315 is the related code for a single tendon.
What should the operative report document?
Document the paralysis, the tendons reconstructed, the operative technique, and the intended functional improvement. The record should support that multiple tendons were treated.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this handled when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction, with payment at 50%.
Can modifier 50 be used for bilateral surgery?
CMS identifies this as a bilateral procedure; reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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.
2,43025310,,Transplant forearm tendon,A,,8.78,9.56,NA,9.56,,1.67,20.01,20.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43125312,,Transplant forearm tendon,A,,9.57,8.43,NA,8.43,,1.88,19.88,19.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43225315,,Revise palsy hand tendon(s),A,,10.41,8.96,NA,8.96,,2.21,21.58,21.58,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43325316,,Revise palsy hand tendon(s),A,,12.58,10.21,NA,10.21,,2.68,25.47,25.47,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43425320,,Repair/revise wrist joint,A,,12.43,12.93,NA,12.93,,2.41,27.77,27.77,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43525332,,Revise wrist joint,A,,11.45,9.53,NA,9.53,,2.22,23.20,23.20,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43625335,,Centralization wrist on ulna,A,,13.06,10.36,NA,10.36,,2.77,26.19,26.19,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014