Billing code 25272: Tendon repairMedicare rate & RVUs in Ohio
Reports secondary repair of a single extensor tendon or muscle in the forearm or wrist, such as delayed reconstruction after an earlier injury.
CMS doesn’t publish an office rate for 25272 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 25272 covers
This service covers secondary repair of one extensor tendon or muscle in the forearm or wrist. It is typically performed by an orthopedic, plastic, or hand surgeon when an extensor structure needs repair after the primary repair opportunity, including delayed treatment of an injury. The operative report should identify the structure and site and explain the secondary nature of the repair.
Select this code for one extensor tendon or muscle when the surgeon documents a secondary repair, rather than a primary repair or repair of a flexor structure. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; 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.
25272 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $514.26 |
How the 25272 rate is calculated
Each of 25272’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 · 25272
RVUs × geographic indexes × conversion factor
Work7.03
7.03 RVUs× 1.000 GPCI
Practice expense7.53
7.53 RVUs× 1.000 GPCI
Malpractice1.48
1.48 RVUs× 1.000 GPCI
Adjusted RVUs
16.0400
Conversion factor
$33.4009
Medicare rate
$535.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25272
25272 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25272
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) | 0 | Not paid without supporting documentation. |
| 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 · 25272
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
25272 without 51 · national facility
$535.75
Tendon repair
25272-51 · Second procedure: 50%
$267.88
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%).
25272 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25270Extensor tendon repair
- Both concern extensor structures in the forearm or wrist. Choose 25270 for a primary repair and 25272 for a secondary repair.
- 25263Tendon repair
- This is the secondary-repair counterpart for a flexor tendon or muscle; 25272 is for an extensor structure.
- 25274Tendon repair
- 25274 is for an additional tendon or muscle in the primary extensor-repair series; 25272 describes secondary repair.
25272 billing questions
How does this differ from 25270?
25270 is for primary repair of an extensor tendon or muscle in the forearm or wrist. Use 25272 when the documented repair is secondary.
How does this differ from 25263?
25263 describes secondary repair of a flexor tendon or muscle. This code is for an extensor structure.
What documentation supports secondary repair?
Document the repaired tendon or muscle, its forearm or wrist location, and why the procedure is secondary rather than primary.
Does the global period include postoperative visits?
Yes. The 90-day global period includes related postoperative care and the preoperative visit on the day before surgery.
Can modifier 50 be reported?
No. Bilateral adjustment is inappropriate for this code.
When is assistant-at-surgery payment allowed?
Only when the record documents medical necessity. Co-surgeons and team surgery are 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 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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