Billing code 25420: Forearm repairMedicare rate & RVUs in Ohio
Operative correction of radius-and-ulna nonunion or malunion using autologous bone graft, reported when both forearm bones require repair.
CMS doesn’t publish an office rate for 25420 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 25420 covers
An orthopedic surgeon uses this service to correct a nonunion or malunion involving both the radius and ulna. The operation addresses the abnormal healing of both forearm bones and uses the patient’s own bone graft to support repair. It is typically performed in an operating room; the code’s grafting work includes obtaining the autograft.
Report this code when the operative documentation supports repair of both bones and use of autologous graft, rather than repair of only one bone or repair without graft. The record should identify the nonunion or malunion, the bones treated, and the graft used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.
25420 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,035.04 |
How the 25420 rate is calculated
Each of 25420’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 · 25420
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.61Practice expense 11.84Malpractice 3.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25420
25420 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25420
Forearm 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 25420
Forearm 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 50 · payment effect
With and without the modifier
25420 without 50 · national facility
$1,068.49
Forearm repair
25420-50 · Bilateral: 150%
$1,602.74
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
25420 compared with similar codes
Compare codes
25420 vs 25400 vs 25405 vs 25415: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25400Forearm bone repair
- 25400 is for nonunion or malunion repair of one forearm bone without graft. This code covers both bones and includes autograft.
- 25405Forearm bone repair
- 25405 covers repair with autograft when only the radius or ulna is treated. This code is for repair of both bones with autograft.
- 25415Forearm bone repair
- 25415 covers repair of both the radius and ulna without graft. Choose this code when autologous bone graft is used.
25420 billing questions
When should this code be chosen over 25415?
Use 25420 when repair of both the radius and ulna includes autologous bone graft. Code 25415 describes repair of both bones without graft.
Can the graft-harvesting work be reported separately?
Obtaining the autograft is included in this repair code. The operative record should identify the graft as autologous.
How does CMS handle bilateral reporting?
For bilateral procedures reported with modifier 50, CMS pays this code at 150%. The operative documentation should support treatment of both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for this repair.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 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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