Billing code 25560: Forearm fracture careMedicare rate & RVUs in Ohio
Reports closed care of fractures through both forearm shafts when the provider treats them without manipulating either fracture for alignment.
Medicare pays $312.09 for 25560 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 25560 covers
This code fits a fracture of the radius and ulna shafts in the same forearm when the provider manages the injuries closed and does not manipulate them to correct alignment. A typical case is a stable both-bone forearm fracture treated with immobilization, such as a cast or splint. Orthopedic surgeons and other qualified physicians may provide this care in an office, emergency department, or facility setting.
Documentation should identify fractures of both shafts, the affected side, the closed treatment plan, and that no manipulation was performed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery services are not 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.
25560 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $312.09 | $258.72 |
How the 25560 rate is calculated
Each of 25560’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 · 25560
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.53Practice expense 6.90Malpractice 0.51
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25560
25560 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25560
Forearm fracture care
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 25560
Forearm fracture care
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
25560 without 50 · national office
$332.00
Forearm fracture care
25560-50 · Bilateral: 150%
$498.00
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).
25560 compared with similar codes
Compare codes
25560 vs 25500 vs 25565 vs 25575: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25500Radial fracture care
- 25500 is for a radial shaft fracture alone. Choose 25560 when both the radius and ulna shafts are treated.
- 25565Forearm fracture care
- Both codes address fractures of the radial and ulnar shafts; 25565 includes manipulation, while 25560 is for treatment without manipulation.
- 25575Forearm fracture repair
- 25575 describes operative treatment with internal fixation of both shafts. This code is for closed treatment without manipulation.
25560 billing questions
How does this differ from 25565?
Use 25560 when both shaft fractures are treated without manipulation. Use 25565 when the provider manipulates the fractures as part of closed treatment.
Can I also report 25500 or 25530 for the same forearm?
No. This code represents treatment of both shaft fractures in that forearm; do not separately report a single-bone treatment code for the same fractures.
Is the cast or splint reported separately?
Routine immobilization associated with the fracture treatment is part of the treatment service. The code includes related postoperative care within its 90-day global period.
How is treatment on both forearms reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
What documentation supports choosing this code?
Document that both the radius and ulna shaft fractures are being treated closed, identify the treated side, and show that no manipulation was performed.
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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