No office rate
Choose 25390 when the operation shortens the radius or ulna. This code is for shortening a carpal bone.
On this page
CMS RVU26D · Effective 2026-10-01
25394 Carpal osteotomy Medicare reimbursement rates in Iowa
Reports an operation that shortens a carpal bone, such as the lunate, to address selected wrist disorders involving carpal bone mechanics. Compare 25394 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 25394 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
$664.08
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.
Hand surgery
About 25394: Carpal bone shortening osteotomy
Reports an operation that shortens a carpal bone, such as the lunate, to address selected wrist disorders involving carpal bone mechanics.
This service involves surgically removing or reshaping bone to shorten a carpal bone, such as the lunate. A hand or orthopedic surgeon may perform it for selected wrist conditions in which changing carpal bone length is part of the treatment plan; lunate disorders such as Kienböck disease are one clinical context. The operative report should identify the bone and describe the shortening procedure performed.
Report this code for shortening a carpal bone, not for an osteotomy that shortens the radius or ulna. Documentation should support the affected bone, side, indication, and procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25394
- 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 RVU10.58 · 48%
- Practice expense (office) RVU9.19 · 42%
- Malpractice RVU2.25 · 10%
45
Medicare services in 2024 · #5411 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.
25394 compared with similar codes
Office rates for Iowa, from the same CMS release.
Compare 25394 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
$664.08
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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 25394 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,448
- Code
- 25394
- Physician work
- 10.58
- Practice expense
- 9.19
- Malpractice
- 2.25
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.58 | × 1.000 | 10.5800 |
| Practice expense | 9.19 | × 0.915 | 8.4088 |
| Malpractice | 2.25 | × 0.397 | 0.8933 |
| Total RVUs | 19.8821 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$664.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.58 | 1 |
| Practice expense | 9.19 | 0.915 |
| Malpractice | 2.25 | 0.397 |
(10.58 × 1 + 9.19 × 0.915 + 2.25 × 0.397) × $33.4009 = $664.08
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.
25394 billing questions
How does this differ from a forearm-bone shortening code?
This code is for shortening a carpal bone in the wrist. Use the radius or ulna codes when the osteotomy shortens one or both forearm bones.
What should the operative report identify?
Document the carpal bone treated, the side, the clinical indication, and the shortening procedure performed.
Can modifier 50 be used for bilateral work?
Yes. CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and additional procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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.
2,44525391,,Lengthen radius or ulna,A,,13.92,10.63,NA,10.63,,2.97,27.52,27.52,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44625392,,Shorten radius & ulna,A,,14.22,10.72,NA,10.72,,3.03,27.97,27.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44725393,,Lengthen radius & ulna,A,,16.15,11.34,NA,11.34,,3.44,30.93,30.93,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44825394,,Repair carpal bone shorten,A,,10.58,9.19,NA,9.19,,2.25,22.02,22.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44925400,,Repair radius or ulna,A,,11.00,8.91,NA,8.91,,2.16,22.07,22.07,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45025405,,Repair/graft radius or ulna,A,,14.63,10.62,NA,10.62,,2.87,28.12,28.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45125415,,Repair radius & ulna,A,,13.46,10.48,NA,10.48,,2.87,26.81,26.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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