No office rate
25400 is for nonunion or malunion repair of one forearm bone without graft. This code covers both bones and includes autograft.
On this page
CMS RVU26D · Effective 2026-10-01
25420 Forearm repair Medicare reimbursement rates in Maine
Operative correction of radius-and-ulna nonunion or malunion using autologous bone graft, reported when both forearm bones require repair. Compare 25420 office and facility rates across CMS payment localities in Maine.
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 25420 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$992.16–$1021.31
2 of 2 localities have a supported rate.
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 25420: Radius and ulna nonunion repair with autograft
Operative correction of radius-and-ulna nonunion or malunion using autologous bone graft, reported when both forearm bones require repair.
An orthopedic surgeon uses this service to correct a nonunion or malunion involving both the radius and ulna. The operation addresses the abnormal healing of both forearm bones and uses the patient’s own bone graft to support repair. It is typically performed in an operating room; the code’s grafting work includes obtaining the autograft.
Report this code when the operative documentation supports repair of both bones and use of autologous graft, rather than repair of only one bone or repair without graft. The record should identify the nonunion or malunion, the bones treated, and the graft used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25420
- 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 RVU16.61 · 52%
- Practice expense (office) RVU11.84 · 37%
- Malpractice RVU3.54 · 11%
43
Medicare services in 2024 · #5442 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.
25420 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
25405 covers repair with autograft when only the radius or ulna is treated. This code is for repair of both bones with autograft.
No office rate
25415 covers repair of both the radius and ulna without graft. Choose this code when autologous bone graft is used.
Compare 25420 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$992.16
Southern Maine →
Office / nonfacility
Unavailable
Facility
$1021.31
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25420 billing questions
When should this code be chosen over 25415?
Use 25420 when repair of both the radius and ulna includes autologous bone graft. Code 25415 describes repair of both bones without graft.
Can the graft-harvesting work be reported separately?
Obtaining the autograft is included in this repair code. The operative record should identify the graft as autologous.
How does CMS handle bilateral reporting?
For bilateral procedures reported with modifier 50, CMS pays this code at 150%. The operative documentation should support treatment of both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for this repair.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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.
2,44925400,,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
2,45225420,,Repair/graft radius & ulna,A,,16.61,11.84,NA,11.84,,3.54,31.99,31.99,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45325425,,Repair/graft radius or ulna,A,,13.38,10.45,NA,10.45,,2.85,26.68,26.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45425426,,Repair/graft radius & ulna,A,,16.04,11.30,NA,11.30,,3.41,30.75,30.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45525430,,Vasc graft into carpal bone,A,,9.47,9.33,NA,9.33,,2.02,20.82,20.82,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00