$312.09
Use 25560 for closed treatment of both radius and ulna shaft fractures without manipulation. This code requires manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
25565 Forearm fracture care Medicare reimbursement rates in Ohio
Reports closed manipulation and treatment of shaft fractures of both the radius and ulna, such as a displaced both-bone forearm fracture. Compare 25565 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 25565 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
$590.06
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$486.07
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 fracture care
About 25565: Closed reduction of both forearm shaft fractures
Reports closed manipulation and treatment of shaft fractures of both the radius and ulna, such as a displaced both-bone forearm fracture.
This service covers closed treatment of shaft fractures of both forearm bones, the radius and ulna, when manipulation is performed to restore alignment. A typical case is a displaced both-bone forearm fracture managed without surgical exposure or internal fixation. An orthopedic surgeon commonly provides the reduction in an emergency department or fracture clinic, then immobilizes the arm and assesses alignment with imaging.
Report the code when the physician treats both shaft fractures with manipulation; documentation should identify both fractures and support the reduction performed. A single-bone fracture, treatment without manipulation, or operative fixation points to a different code. The 90-day global period 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 is paid in full and other procedures are subject to the standard 50% reduction. For bilateral services reported with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 25565
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.70 · 31%
- Practice expense (office) RVU11.66 · 62%
- Malpractice RVU1.31 · 7%
453
Medicare services in 2024 · #3650 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.
25565 compared with similar codes
Office rates for Ohio, from the same CMS release.
$558.08
25505 is for a radial shaft fracture treated with manipulation; this code covers shaft fractures of both the radius and ulna.
$519.05
25535 is for an ulnar shaft fracture treated with manipulation; this code covers both forearm bones.
No office rate
25575 describes operative treatment with internal fixation of both shaft fractures. This code is for closed treatment with manipulation, without fixation.
Compare 25565 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
$590.06
Facility
$486.07
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 25565 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,482
- Code
- 25565
- Physician work
- 5.70
- Practice expense
- 11.66
- Malpractice
- 1.31
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.70 | × 1.000 | 5.7000 |
| Practice expense | 11.66 | × 0.913 | 10.6456 |
| Malpractice | 1.31 | × 1.008 | 1.3205 |
| Total RVUs | 17.6661 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$590.06
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.7 | 1 |
| Practice expense | 11.66 | 0.913 |
| Malpractice | 1.31 | 1.008 |
(5.7 × 1 + 11.66 × 0.913 + 1.31 × 1.008) × $33.4009 = $590.06
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.7 | 1 |
| Practice expense | 8.25 | 0.913 |
| Malpractice | 1.31 | 1.008 |
(5.7 × 1 + 8.25 × 0.913 + 1.31 × 1.008) × $33.4009 = $486.07
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.
25565 billing questions
How is this different from 25560?
25560 covers closed treatment of radius and ulna shaft fractures without manipulation. Use 25565 when the physician manipulates the fractures to restore alignment.
Can this code be used for a fracture of only one forearm bone?
No. It is for shaft fractures of both the radius and ulna treated with manipulation. A single-bone fracture requires the code for that bone and treatment method.
Is immobilization separately reported?
Immobilization is part of the closed fracture treatment. Do not separately report cast or splint application as a distinct service when it is included in the fracture care.
What documentation supports reporting 25565?
Document shaft fractures of both bones, the closed manipulation performed, and the resulting alignment and immobilization. Imaging findings can support the fracture diagnoses and reduction.
How does the global period affect follow-up visits?
The 90-day global period includes related postoperative care and the day-before preoperative visit. Routine follow-up for the treated fractures is included during that period.
Can an assistant or co-surgeon be billed for this procedure?
CMS restricts assistant-at-surgery payment for this code and does not permit co-surgeons or team surgery.
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.
2,47925535,,Cltx ulnar shft fx w/mnpj,A,,5.23,10.10,,7.26,,1.08,16.41,13.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48025545,,Optx ulnar shft fx int fixj,A,,7.74,8.51,NA,8.51,,1.56,17.81,17.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48125560,,Cltx rdl&uln shft fx wo mnpj,A,,2.53,6.90,,5.15,,0.51,9.94,8.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48225565,,Cltx rdl&uln shft fx w/mnpj,A,,5.70,11.66,,8.25,,1.31,18.67,15.26,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48325574,,Optx rdl&uln shft fx rds/uln,A,,8.58,8.86,NA,8.86,,1.75,19.19,19.19,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48425575,,Optx rdl&uln shft fx rds&uln,A,,11.98,10.86,NA,10.86,,2.48,25.32,25.32,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48525600,,Cltx dst rdl fx/ephys sep wo,A,,2.71,8.28,,6.98,,0.55,11.54,10.24,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,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