25425 Forearm bone repair Medicare reimbursement rates in Kansas

This code describes graft-assisted reconstruction of a nonunion or malunion in one forearm bone: the radius or the ulna. An orthopedic surgeon may use it when a prior fracture has failed to unite or has healed in a position requiring operative correction and grafting. The work takes place in the operating room and addresses the affected bone rather than a wrist joint or carpal bone. The operative report should identify the bone, the nonunion or malunion, the grafting performed, and the repair technique.

Select this code only when the documented operation matches its specific CPT descriptor; distinguish repair of one bone from procedures addressing both radius and ulna, and distinguish the applicable graft technique from other repair options. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.