No office rate
Both codes address a nonunion or malunion of one radius or ulna; 25405 is the grafted repair, while 25400 is for repair without a graft.
On this page
CMS RVU26D · Effective 2026-10-01
25400 Forearm bone repair Medicare reimbursement rates in Ohio
Reports operative repair of a radius or ulna fracture nonunion or malunion when one forearm bone is treated without a graft. Compare 25400 office and facility rates across CMS payment localities in Ohio.
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 25400 in Ohio?
Ohio 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
$711.84
1 of 1 localities have a supported rate.
Payment area: Ohio
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 25400: Radius or ulna nonunion repair
Reports operative repair of a radius or ulna fracture nonunion or malunion when one forearm bone is treated without a graft.
This operation treats a radius or ulna fracture that has failed to unite or has healed in a position requiring correction. An orthopedic surgeon works on the affected forearm bone to address the nonunion or malalignment and restore stability. The service is typically performed in an operating room, including a hospital outpatient department or inpatient setting, rather than as routine fracture follow-up.
Report this code when the repair involves one bone and is performed without a graft; use the applicable family code when both bones or grafting are involved. The operative report should identify the bone, the nonunion or malunion being treated, and the repair performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid 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 25400
- 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 RVU11.00 · 50%
- Practice expense (office) RVU8.91 · 40%
- Malpractice RVU2.16 · 10%
1K
Medicare services in 2024 · #2970 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.
25400 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Use 25415 when the repair involves both the radius and ulna without graft, rather than a single forearm bone.
No office rate
25420 covers grafted repair involving both the radius and ulna; 25400 is for one bone without graft.
Compare 25400 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
Ohio →
Office / nonfacility
Unavailable
Facility
$711.84
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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 25400 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,449
- Code
- 25400
- Physician work
- 11.00
- Practice expense
- 8.91
- Malpractice
- 2.16
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.00 | × 1.000 | 11.0000 |
| Practice expense | 8.91 | × 0.913 | 8.1348 |
| Malpractice | 2.16 | × 1.008 | 2.1773 |
| Total RVUs | 21.3121 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$711.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11 | 1 |
| Practice expense | 8.91 | 0.913 |
| Malpractice | 2.16 | 1.008 |
(11 × 1 + 8.91 × 0.913 + 2.16 × 1.008) × $33.4009 = $711.84
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.
25400 billing questions
When is 25400 appropriate instead of 25405?
Use 25400 for a one-bone radius or ulna repair without a graft. The grafted one-bone repair is represented by 25405.
Can 25400 be reported for both the radius and ulna?
When both forearm bones are repaired, the family includes codes for repair of the radius and ulna together. Do not use 25400 twice to represent that service.
What documentation supports 25400?
Document which bone is repaired, the nonunion or malunion being treated, and the operative work performed. The record should also support that the repair is without a graft.
How does the bilateral payment rule affect reporting?
For bilateral performance, report modifier 50; CMS lists payment at 150%. The operative documentation should support repair on both sides.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%.
Is an assistant or co-surgeon reportable for this operation?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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.
2,44625392,,Shorten radius & ulna,A,,14.22,10.72,NA,10.72,,3.03,27.97,27.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44725393,,Lengthen radius & ulna,A,,16.15,11.34,NA,11.34,,3.44,30.93,30.93,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44825394,,Repair carpal bone shorten,A,,10.58,9.19,NA,9.19,,2.25,22.02,22.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,44925400,,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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703