No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
25575 Forearm fracture repair Medicare reimbursement rates in Hawaii
Reports open operative treatment of shaft fractures of both forearm bones, the radius and ulna, with internal fixation when performed. Compare 25575 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 25575 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
$860.53
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 25575: Open treatment of both forearm shaft fractures
Reports open operative treatment of shaft fractures of both forearm bones, the radius and ulna, with internal fixation when performed.
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.
CMS billing rules for 25575
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.98 · 47%
- Practice expense (office) RVU10.86 · 43%
- Malpractice RVU2.48 · 10%
1.1K
Medicare services in 2024 · #2903 by national volume
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.
25575 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
25515 is for open treatment of a radial shaft fracture alone. Use 25575 when the ulna shaft fracture is also treated.
$658.53
25565 describes closed treatment of both shaft fractures with manipulation. 25575 describes open operative treatment of both.
Compare 25575 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
$860.53
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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 25575 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,484
- Code
- 25575
- Physician work
- 11.98
- Practice expense
- 10.86
- Malpractice
- 2.48
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.98 | × 1.000 | 11.9800 |
| Practice expense | 10.86 | × 1.137 | 12.3478 |
| Malpractice | 2.48 | × 0.579 | 1.4359 |
| Total RVUs | 25.7637 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$860.53
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.98 | 1 |
| Practice expense | 10.86 | 1.137 |
| Malpractice | 2.48 | 0.579 |
(11.98 × 1 + 10.86 × 1.137 + 2.48 × 0.579) × $33.4009 = $860.53
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.
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 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.
2,48125560,,Cltx rdl&uln shft fx wo mnpj,A,,2.53,6.90,,5.15,,0.51,9.94,8.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48225565,,Cltx rdl&uln shft fx w/mnpj,A,,5.70,11.66,,8.25,,1.31,18.67,15.26,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48325574,,Optx rdl&uln shft fx rds/uln,A,,8.58,8.86,NA,8.86,,1.75,19.19,19.19,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48425575,,Optx rdl&uln shft fx rds&uln,A,,11.98,10.86,NA,10.86,,2.48,25.32,25.32,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48525600,,Cltx dst rdl fx/ephys sep wo,A,,2.71,8.28,,6.98,,0.55,11.54,10.24,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48625605,,Cltx dst rdl fx/ephys sep w/,A,,6.09,11.54,,8.99,,1.37,19.00,16.45,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48725606,,Perq skel fixj dstl rdl fx,A,,8.10,9.42,NA,9.42,,1.69,19.21,19.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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