On this page

CMS RVU26D · Effective 2026-10-01

25394 Carpal osteotomy Medicare reimbursement rates in Missouri

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 Missouri.

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 Missouri?

Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$691.17–$720.90

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $29.73 per service.

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.

Find 25394 in your payment locality →

Where 25394 pays more and less in Missouri

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 Missouri, from the same CMS release.

25390

Bone shortening

Radius or ulna

No office rate

Choose 25390 when the operation shortens the radius or ulna. This code is for shortening a carpal bone.

25392

Forearm osteotomy

Both bones shortened

No office rate

25392 covers shortening both forearm bones; this code applies when the shortened bone is carpal.

25391

Bone lengthening

One forearm bone

No office rate

25391 is for lengthening a radius or ulna. This code describes shortening a carpal bone.

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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

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.

RVUs for 25394PPRRVU2026_Oct_nonQPP.csv, line 2,448 (RVU26D)