Billing code 25365: Forearm osteotomyMedicare rate & RVUs in Guam
Reports corrective osteotomy of both forearm bones to address a deformity or malalignment requiring surgical correction of the radius and ulna.
CMS doesn’t publish an office rate for 25365 in Guam.
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 25365 covers
This procedure corrects alignment or deformity by cutting and repositioning both the radius and ulna. An orthopedic or hand surgeon may perform it for a forearm malunion or another acquired or developmental deformity affecting both bones. It is an operative bone procedure, typically performed in a hospital or ambulatory surgery setting; fixation may be used to maintain the corrected position.
Report this code when the operative documentation supports osteotomy of both bones, not just one. The record should identify the treated side, the deformity or malalignment, and the correction performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery may be 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.
25365 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $860.09 |
How the 25365 rate is calculated
Each of 25365’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 · 25365
RVUs × geographic indexes × conversion factor
Work12.59
12.59 RVUs× 1.000 GPCI
Practice expense10.21
10.21 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
25.4800
Conversion factor
$33.4009
Medicare rate
$851.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25365
25365 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25365
Forearm osteotomy
| 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 · 25365
Forearm osteotomy
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
25365 without 50 · national facility
$851.05
Forearm osteotomy
25365-50 · Bilateral: 150%
$1,276.58
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).
25365 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 25350Radius osteotomy
- This code addresses both radius and ulna. Code 25350 is for an osteotomy involving the radius alone.
- 25360Ulnar osteotomy
- This code addresses both forearm bones. Code 25360 is for an osteotomy involving the ulna alone.
- 25375Forearm osteotomy
- Use 25375 when the documented paired-bone osteotomy includes lengthening; this code describes corrective osteotomy of both bones without that specific lengthening distinction.
- 25392Forearm osteotomy
- Code 25392 describes shortening both radius and ulna. Choose this code when shortening, rather than another corrective alignment procedure, is the documented objective.
25365 billing questions
When should I report this instead of a single-bone osteotomy?
Report this code when the surgeon osteotomizes both the radius and ulna. If only one bone is treated, consider the code for that specific bone and procedure.
Is this the right code for shortening or lengthening both bones?
Use this code for corrective osteotomy of both bones when the documented procedure is not specifically a shortening or lengthening service. Compare the dedicated paired-bone shortening and lengthening codes when that is the planned correction.
What documentation supports reporting this code?
Document the treated side, the deformity or malalignment, that both the radius and ulna were osteotomized, and how the bones were repositioned.
How does the bilateral payment rule work?
For bilateral surgery, report modifier 50; CMS pays this procedure at 150%.
Can an assistant surgeon be reported?
An assistant at surgery may be paid for this procedure. Co-surgeons and team surgery are not permitted under the listed CMS rules.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 25365 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 →