No office rate
Choose 25275 when the extensor tendon repair includes tendon sheath transplantation. Choose 25274 for repair with a free tendon graft.
On this page
CMS RVU26D · Effective 2026-10-01
25275 Tendon repair Medicare reimbursement rates in Iowa
Reports repair of an extensor tendon at the forearm or wrist when the procedure includes transplantation of the tendon sheath. Compare 25275 office and facility rates across CMS payment localities in Iowa.
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 25275 in Iowa?
Iowa 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
$566.99
1 of 1 localities have a supported rate.
Payment area: Iowa
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 25275: Extensor tendon sheath reconstruction
Reports repair of an extensor tendon at the forearm or wrist when the procedure includes transplantation of the tendon sheath.
An orthopedic or hand surgeon uses this service to repair an extensor tendon in the forearm or wrist while transplanting or reconstructing its sheath. The sheath work distinguishes the procedure from a repair limited to tendon tissue. It is generally performed in an operating room for an injury or other tendon problem requiring both tendon repair and sheath reconstruction.
Select the code when the operative report supports extensor tendon repair with tendon sheath transplantation; document the affected side, tendon, and work performed. The 90-day global period includes 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 the others at 50%. Modifier 50 identifies a bilateral procedure, paid at 150%. Assistant-at-surgery payment requires medical-necessity documentation, and co-surgeon payment requires supporting documentation; team surgery is not permitted.
CMS billing rules for 25275
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.74 · 47%
- Practice expense (office) RVU8.28 · 44%
- Malpractice RVU1.66 · 9%
315
Medicare services in 2024 · #3958 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.
25275 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
25270 describes primary extensor tendon repair without the sheath-transplantation feature. The sheath transplantation is the distinguishing work for 25275.
No office rate
25272 describes secondary extensor tendon repair without the sheath-transplantation feature. Report 25275 when the repair includes tendon sheath transplantation.
No office rate
25295 addresses release of a tendon to free it from adhesions. It is not the tendon repair with sheath transplantation represented by 25275.
Compare 25275 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
Iowa →
Office / nonfacility
Unavailable
Facility
$566.99
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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 25275 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,424
- Code
- 25275
- Physician work
- 8.74
- Practice expense
- 8.28
- Malpractice
- 1.66
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.74 | × 1.000 | 8.7400 |
| Practice expense | 8.28 | × 0.915 | 7.5762 |
| Malpractice | 1.66 | × 0.397 | 0.6590 |
| Total RVUs | 16.9752 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$566.99
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.74 | 1 |
| Practice expense | 8.28 | 0.915 |
| Malpractice | 1.66 | 0.397 |
(8.74 × 1 + 8.28 × 0.915 + 1.66 × 0.397) × $33.4009 = $566.99
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.
25275 billing questions
How is this different from 25274?
25275 is for extensor tendon repair that includes tendon sheath transplantation. Use 25274 when the repair uses a free tendon graft rather than the sheath-transplantation service.
Can the tendon repair and sheath work be reported separately?
The defining service includes extensor tendon repair with tendon sheath transplantation. The operative report should establish that combination rather than describe tendon repair alone.
What documentation supports reporting 25275?
Document the forearm or wrist site, the extensor tendon repaired, and the tendon sheath transplantation or reconstruction performed. The operative note should make clear how the sheath work was part of the repair.
How is a bilateral procedure reported?
Use modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and 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.
2,42125270,,Repair forearm tendon/muscle,A,,6.02,6.89,NA,6.89,,1.19,14.10,14.10,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42225272,,Repair forearm tendon/muscle,A,,7.03,7.53,NA,7.53,,1.48,16.04,16.04,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42325274,,Repair forearm tendon/muscle,A,,8.72,8.08,NA,8.08,,1.64,18.44,18.44,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42425275,,Repair forearm tendon sheath,A,,8.74,8.28,NA,8.28,,1.66,18.68,18.68,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42525280,,Revise wrist/forearm tendon,A,,7.21,7.32,NA,7.32,,1.41,15.94,15.94,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42625290,,Incise wrist/forearm tendon,A,,5.29,6.11,NA,6.11,,1.01,12.41,12.41,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42725295,,Release wrist/forearm tendon,A,,6.55,7.07,NA,7.07,,1.26,14.88,14.88,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136