CPT 25263: Tendon repairMedicare rate & RVUs in Ohio
Reports primary repair of a single extensor tendon or muscle in the forearm or wrist, such as direct repair after an acute injury.
CMS doesn’t publish an office rate for 25263 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 25263 covers
This code represents primary surgical repair of one extensor tendon or muscle in the forearm or wrist. A hand, orthopedic, or plastic surgeon may use it to restore continuity after an acute injury, such as a laceration with tendon damage, when the tissue can be repaired directly. The work centers on identifying the injured structure and securing its ends; it is not the code for a delayed reconstruction or a repair requiring a graft.
Report the code for each tendon or muscle repaired, with the operative note identifying the structure, injury, repair method, and why the repair is primary. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
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.
25263 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $583.09 |
How the 25263 rate is calculated
Each of 25263’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 25263
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.84Practice expense 8.69Malpractice 1.67
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25263
25263 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25263
Tendon repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25263
Tendon repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
25263 without 51 · national facility
$607.90
Tendon repair
25263-51 · Second procedure: 50%
$303.95
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
25263 compared with similar codes
Compare codes
25263 vs 25260 vs 25265 vs 25270 vs 25272: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25260Flexor tendon repair
- Choose 25260 for primary repair of a flexor tendon or muscle; choose 25263 for a primary extensor repair.
- 25265Flexor tendon repair
- 25265 describes secondary repair of a flexor tendon or muscle. It is not the primary extensor repair represented by 25263.
- 25270Extensor tendon repair
- 25270 is for secondary repair of an extensor tendon or muscle. Use 25263 for primary repair.
- 25272Tendon repair
- 25272 is a secondary extensor repair code involving a free graft; 25263 describes primary repair.
25263 billing questions
How does this differ from 25260?
25263 is for primary repair of an extensor tendon or muscle. 25260 is the corresponding primary repair code for a flexor tendon or muscle.
When is a secondary repair code more appropriate?
Use a secondary repair code when the surgeon is reconstructing a delayed injury rather than primarily repairing the tendon or muscle. The operative report should support the timing and nature of the repair.
Is the code reported per tendon?
Yes. The code describes a single tendon or muscle, so document each structure repaired and report units according to the applicable coding instructions.
Does the repair include related postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for repairs on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
May an assistant surgeon be reported?
An assistant at surgery may be paid for this procedure. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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