No office rate
Choose 25455 when the distal radius and ulna are both treated on the same side; 25450 covers either bone alone.
On this page
CMS RVU26D · Effective 2026-10-01
25450 Physeal arrest Medicare reimbursement rates in Nebraska
Surgical growth-plate arrest of one distal forearm bone is reported to manage a growth-related wrist deformity or length discrepancy. Compare 25450 office and facility rates across CMS payment localities in Nebraska.
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 25450 in Nebraska?
Nebraska 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
$534.56
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 25450: Distal radius or ulna epiphysiodesis
Surgical growth-plate arrest of one distal forearm bone is reported to manage a growth-related wrist deformity or length discrepancy.
An orthopedic surgeon performs this operation to stop growth at the distal growth plate of either the radius or the ulna. It may be considered when continued growth is expected to worsen a wrist or forearm deformity or contribute to a limb-length discrepancy. The operative report should identify the bone and side treated and describe the growth-related problem and the procedure performed.
Report 25450 for one bone; when both the distal radius and ulna are treated on the same side, use 25455. For the same procedure on both sides, CMS recognizes modifier 50 and pays at 150%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures at 50%. CMS does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 25450
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.86 · 44%
- Practice expense (office) RVU8.14 · 46%
- Malpractice RVU1.67 · 9%
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.
25450 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
25400 describes repair of a radius or ulna nonunion or malunion, not arrest of growth at a distal physis.
No office rate
25405 is a radius or ulna repair involving grafting; 25450 addresses growth arrest rather than bone repair.
Compare 25450 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$534.56
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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 25450 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,467
- Code
- 25450
- Physician work
- 7.86
- Practice expense
- 8.14
- Malpractice
- 1.67
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.86 | × 1.000 | 7.8600 |
| Practice expense | 8.14 | × 0.923 | 7.5132 |
| Malpractice | 1.67 | × 0.378 | 0.6313 |
| Total RVUs | 16.0045 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$534.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.86 | 1 |
| Practice expense | 8.14 | 0.923 |
| Malpractice | 1.67 | 0.378 |
(7.86 × 1 + 8.14 × 0.923 + 1.67 × 0.378) × $33.4009 = $534.56
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.
25450 billing questions
When should 25450 be reported instead of 25455?
Use 25450 when the procedure arrests growth in either the distal radius or the distal ulna. Use 25455 when both bones are treated on the same side.
How should the procedure be reported when both sides are treated?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the bone or bones treated and the side of each procedure.
Does the global period include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 25450?
Document the growth-related indication, the specific distal forearm bone and side treated, and the operative work performed. The record should make clear that one bone, rather than both distal bones on that side, was treated.
How is 25450 paid when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,46425447,,Arthrp ntrcrp/crp/mtcr ntrps,A,,10.24,10.07,NA,10.07,,1.96,22.27,22.27,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46525448,,Arthrp ntrcrpl/crp/mtcrp ssp,A,,11.55,10.78,NA,10.78,,2.20,24.53,24.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46625449,,Revj arthrp wrist joint,A,,14.57,10.53,NA,10.53,,2.81,27.91,27.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46725450,,Epiphysl arrst dstl rds/ulna,A,,7.86,8.14,NA,8.14,,1.67,17.67,17.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46825455,,Epiphysl arrst dstl rds&ulna,A,,9.47,9.21,NA,9.21,,2.02,20.70,20.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46925490,,Prophylactic tx radius,A,,9.49,8.81,NA,8.81,,2.02,20.32,20.32,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47025491,,Prophylactic tx ulna,A,,9.90,8.79,NA,8.79,,2.11,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068