No office rate
25450 is for arrest of one distal forearm growth plate; 25455 is for both the radius and ulna.
On this page
CMS RVU26D · Effective 2026-10-01
25455 Growth arrest Medicare reimbursement rates in Hawaii
Surgical growth arrest of both distal forearm physes is reported when a skeletally immature patient needs growth controlled at the radius and ulna. Compare 25455 office and facility rates across CMS payment localities in Hawaii.
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 25455 in Hawaii?
Hawaii 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
$705.14
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.
Orthopedic surgery
About 25455: Distal radius and ulna growth arrest
Surgical growth arrest of both distal forearm physes is reported when a skeletally immature patient needs growth controlled at the radius and ulna.
This operation intentionally stops growth at the distal radius and ulna, the growth plates near the wrist. Pediatric orthopedic surgeons may perform it to address a developing wrist deformity or growth imbalance in a skeletally immature patient. The procedure involves treating both physes in the same forearm; it is distinct from repairing a fracture or a bone nonunion.
Report 25455 when the surgeon documents arrest of both distal physes on one side. If only one bone’s growth plate is treated, the single-bone code 25450 is the relevant sibling. The operative report should identify the treated bones and side, the growth-related indication, and the procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When procedures are performed in the same session, the highest-valued is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 25455
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.47 · 46%
- Practice expense (office) RVU9.21 · 44%
- Malpractice RVU2.02 · 10%
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.
25455 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
25400 describes a radius or ulna repair, not intentional arrest of the distal growth plates.
No office rate
25405 is a radius or ulna repair involving grafting; 25455 treats growth at both distal physes.
Compare 25455 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
$705.14
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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 25455 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,468
- Code
- 25455
- Physician work
- 9.47
- Practice expense
- 9.21
- Malpractice
- 2.02
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.47 | × 1.000 | 9.4700 |
| Practice expense | 9.21 | × 1.137 | 10.4718 |
| Malpractice | 2.02 | × 0.579 | 1.1696 |
| Total RVUs | 21.1114 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$705.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.47 | 1 |
| Practice expense | 9.21 | 1.137 |
| Malpractice | 2.02 | 0.579 |
(9.47 × 1 + 9.21 × 1.137 + 2.02 × 0.579) × $33.4009 = $705.14
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.
25455 billing questions
When should 25455 be chosen over 25450?
Use 25455 when the surgeon arrests both the distal radius and distal ulna growth plates in the same forearm. Use 25450 when the operation treats only one of those bones.
Can the procedure be reported bilaterally?
Yes. When both forearms undergo the procedure, report bilateral services with modifier 50; CMS pays the bilateral procedure at 150%.
What documentation supports reporting 25455?
The operative report should show that both distal physes were treated, identify the side or sides, and describe the growth-related reason for arrest.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
CMS applies a statutory restriction to assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid 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 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.
2,46525448,,Arthrp ntrcrpl/crp/mtcrp ssp,A,,11.55,10.78,NA,10.78,,2.20,24.53,24.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46625449,,Revj arthrp wrist joint,A,,14.57,10.53,NA,10.53,,2.81,27.91,27.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46725450,,Epiphysl arrst dstl rds/ulna,A,,7.86,8.14,NA,8.14,,1.67,17.67,17.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46825455,,Epiphysl arrst dstl rds&ulna,A,,9.47,9.21,NA,9.21,,2.02,20.70,20.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46925490,,Prophylactic tx radius,A,,9.49,8.81,NA,8.81,,2.02,20.32,20.32,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47025491,,Prophylactic tx ulna,A,,9.90,8.79,NA,8.79,,2.11,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47125492,,Prophylactic tx radius&ulna,A,,12.34,10.29,NA,10.29,,2.62,25.25,25.25,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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