Billing code 25035: Bone incisionMedicare rate & RVUs in Oregon
Opening the cortex of a forearm or wrist bone provides surgical access to infected bone, such as in osteomyelitis or a bone abscess.
CMS doesn’t publish an office rate for 25035 in Oregon.
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 25035 covers
This operation opens the outer layer of a forearm or wrist bone to reach an infected area, such as osteomyelitis or a bone abscess, for drainage or debridement. An orthopedic surgeon typically performs it in a hospital or ambulatory surgery setting. The target is bone, not an abscess limited to soft tissue, a bursa, or a wrist joint.
Report the code when the operative work includes an incision through the bone cortex; document the affected bone, side, indication, and the work performed. It has a 90-day global period, including 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented 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.
Where 25035 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $582.86 |
| Rest Of Oregon | Unavailable | $546.66 |
How the 25035 rate is calculated
Each of 25035’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 · 25035
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.46Practice expense 7.82Malpractice 1.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25035
25035 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25035
Bone incision
| 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) | 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 · 25035
Bone incision
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
25035 without 50 · national facility
$563.47
Bone incision
25035-50 · Bilateral: 150%
$845.21
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).
25035 compared with similar codes
Compare codes
25035 vs 25028 vs 25031 vs 25040: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25028Collection drainage
- Choose 25035 for cortical access to infected forearm or wrist bone. Choose 25028 when drainage is directed at a deep soft-tissue abscess or hematoma.
- 25031Bursal drainage
- 25031 is directed at a forearm or wrist bursa; 25035 is directed at bone cortex.
- 25040Wrist arthrotomy
- 25040 describes an operation on the wrist or midcarpal joint. Use 25035 when the operative target is forearm or wrist bone.
25035 billing questions
When is this code preferable to a deep forearm or wrist abscess drainage code?
Use this code when the surgeon opens the bone cortex to address infected bone. A deep soft-tissue abscess without bone work points to a soft-tissue drainage code instead.
Does it describe drainage of a wrist joint or bursa?
No. The target is bone cortex; a procedure directed at the wrist joint or a bursa is coded according to that structure and the work performed.
What documentation supports reporting it?
Document the affected forearm or wrist bone, laterality, the bone infection or abscess being treated, and the cortical incision and work performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is it paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of 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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