No office rate
Both describe secondary extensor tendon repair in the forearm or wrist. Choose 25274 when a free graft is used; choose 25272 when repair is performed without one.
On this page
CMS RVU26D · Effective 2026-10-01
25274 Tendon repair Medicare reimbursement rates in Kentucky
Reports secondary reconstruction of a forearm or wrist extensor tendon using a free graft when direct tendon repair is not the selected approach. Compare 25274 office and facility rates across CMS payment localities in Kentucky.
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 25274 in Kentucky?
Kentucky 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
$581.30
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 25274: Secondary extensor tendon repair with graft
Reports secondary reconstruction of a forearm or wrist extensor tendon using a free graft when direct tendon repair is not the selected approach.
A hand or orthopedic surgeon uses this service to restore continuity of an extensor tendon in the forearm or wrist when secondary repair requires a free tendon graft. It may be chosen for a chronic tendon defect or a gap that cannot be managed by direct approximation. The graft is included in the service, including obtaining it, and the code is reported for each tendon treated.
Documentation should identify the extensor tendon, its forearm or wrist location, the secondary nature of the repair, and use of a free graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25274
- 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 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 RVU8.72 · 47%
- Practice expense (office) RVU8.08 · 44%
- Malpractice RVU1.64 · 9%
119
Medicare services in 2024 · #4743 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.
25274 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
25270 describes primary extensor tendon repair. This code is for secondary repair using a free graft.
No office rate
25265 is the corresponding secondary free-graft repair for a flexor tendon. This code applies to an extensor tendon.
Compare 25274 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$581.30
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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 25274 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,423
- Code
- 25274
- Physician work
- 8.72
- Practice expense
- 8.08
- Malpractice
- 1.64
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.72 | × 1.000 | 8.7200 |
| Practice expense | 8.08 | × 0.889 | 7.1831 |
| Malpractice | 1.64 | × 0.915 | 1.5006 |
| Total RVUs | 17.4037 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$581.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.72 | 1 |
| Practice expense | 8.08 | 0.889 |
| Malpractice | 1.64 | 0.915 |
(8.72 × 1 + 8.08 × 0.889 + 1.64 × 0.915) × $33.4009 = $581.30
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.
25274 billing questions
When should this code be chosen over 25272?
Use this code when the secondary extensor tendon repair uses a free graft. Code 25272 describes secondary repair without a free graft.
Does the code include obtaining the graft?
Yes. Graft acquisition is included in the service, so it is not separately reported as a distinct graft-harvesting service for this repair.
How are units counted?
Report one unit for each extensor tendon repaired with a free graft. The operative note should identify each tendon treated.
Can modifier 50 be used for bilateral repairs?
No. CMS identifies modifier 50 as inappropriate for this code. Report the services according to the documented procedures and applicable claim rules.
What documentation supports assistant or co-surgeon payment?
Assistant-at-surgery payment requires documentation of medical necessity. 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.
2,42025265,,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
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
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631