No office rate
Both describe secondary flexor tendon repair in the forearm or wrist. Choose 25265 when the reconstruction uses a free graft; choose 25263 when it does not.
On this page
CMS RVU26D · Effective 2026-10-01
25265 Flexor tendon repair Medicare reimbursement rates in Kansas
Reports secondary repair of a forearm or wrist flexor tendon when reconstruction requires a free tendon graft, including graft harvest. Compare 25265 office and facility rates across CMS payment localities in Kansas.
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 25265 in Kansas?
Kansas 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
$629.01
1 of 1 localities have a supported rate.
Payment area: Kansas
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 25265: Secondary flexor tendon repair with graft
Reports secondary repair of a forearm or wrist flexor tendon when reconstruction requires a free tendon graft, including graft harvest.
This operation reconstructs a flexor tendon in the forearm or wrist during a secondary repair, using a free graft to bridge or replace damaged tendon. A hand or orthopedic surgeon may perform it when a tendon cannot be repaired directly, such as after a delayed presentation or a prior repair that did not restore continuity. The surgeon obtains and places the graft as part of the reconstruction, then secures it to restore the tendon’s path and function.
Report the code for each flexor tendon repaired; the operative note should identify the tendon, the secondary nature of the repair, and use of a free graft. Graft harvest is included. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code’s descriptor and anatomy. CMS permits assistant-at-surgery payment; co-surgeons and team surgery are not permitted.
CMS billing rules for 25265
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.85 · 48%
- Practice expense (office) RVU8.91 · 43%
- Malpractice RVU1.84 · 9%
175
Medicare services in 2024 · #4440 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.
25265 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
25260 is for primary flexor tendon repair without a graft. 25265 is for secondary repair requiring a free graft.
No office rate
25274 covers secondary extensor tendon repair with a free graft. 25265 is for a flexor tendon.
No office rate
25272 is secondary extensor tendon repair without a graft; 25265 is secondary flexor tendon repair with a free graft.
Compare 25265 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
Kansas →
Office / nonfacility
Unavailable
Facility
$629.01
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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 25265 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,420
- Code
- 25265
- Physician work
- 9.85
- Practice expense
- 8.91
- Malpractice
- 1.84
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.85 | × 1.000 | 9.8500 |
| Practice expense | 8.91 | × 0.904 | 8.0546 |
| Malpractice | 1.84 | × 0.504 | 0.9274 |
| Total RVUs | 18.8320 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$629.01
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.85 | 1 |
| Practice expense | 8.91 | 0.904 |
| Malpractice | 1.84 | 0.504 |
(9.85 × 1 + 8.91 × 0.904 + 1.84 × 0.504) × $33.4009 = $629.01
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.
25265 billing questions
When is 25265 selected instead of 25263?
Use 25265 for a secondary flexor tendon repair that uses a free graft. Code 25263 describes secondary flexor tendon repair without a graft.
Is graft harvest separately reportable?
No. The graft harvest is included in 25265.
How many units should be reported?
Report one unit for each flexor tendon repaired. The operative report should identify the tendon or tendons treated.
Should modifier 50 be used for repairs on both sides?
No. The descriptor and anatomy make modifier 50 inappropriate; report the tendon repairs rather than a bilateral procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for this procedure. Co-surgeons and team surgery are 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.
2,41725259,,Manipulate wrist w/anesthes,A,,3.94,8.36,NA,8.36,,0.79,13.09,13.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41825260,,Repair forearm tendon/muscle,A,,7.84,8.59,NA,8.59,,1.51,17.94,17.94,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41925263,,Repair forearm tendon/muscle,A,,7.84,8.69,NA,8.69,,1.67,18.20,18.20,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42025265,,Repair forearm tendon/muscle,A,,9.85,8.91,NA,8.91,,1.84,20.60,20.60,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958