Billing code 25265: Flexor tendon repairMedicare rate & RVUs in Oregon
Reports secondary repair of a forearm or wrist flexor tendon when reconstruction requires a free tendon graft, including graft harvest.
CMS doesn’t publish an office rate for 25265 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 25265 covers
This operation reconstructs a flexor tendon in the forearm or wrist during a secondary repair, using a free graft to bridge or replace damaged tendon. A hand or orthopedic surgeon may perform it when a tendon cannot be repaired directly, such as after a delayed presentation or a prior repair that did not restore continuity. The surgeon obtains and places the graft as part of the reconstruction, then secures it to restore the tendon’s path and function.
Report the code for each flexor tendon repaired; the operative note should identify the tendon, the secondary nature of the repair, and use of a free graft. Graft harvest is included. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code’s descriptor and anatomy. CMS permits assistant-at-surgery payment; 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 25265 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $710.62 |
| Rest Of Oregon | Unavailable | $668.62 |
How the 25265 rate is calculated
Each of 25265’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 · 25265
RVUs × geographic indexes × conversion factor
Work9.85
9.85 RVUs× 1.000 GPCI
Practice expense8.91
8.91 RVUs× 1.000 GPCI
Malpractice1.84
1.84 RVUs× 1.000 GPCI
Adjusted RVUs
20.6000
Conversion factor
$33.4009
Medicare rate
$688.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25265
25265 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25265
Flexor tendon 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 25265
Flexor tendon 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 51 · payment effect
With and without the modifier
25265 without 51 · national facility
$688.06
Flexor tendon repair
25265-51 · Second procedure: 50%
$344.03
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
25265 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 25263Tendon repair
- Both describe secondary flexor tendon repair in the forearm or wrist. Choose 25265 when the reconstruction uses a free graft; choose 25263 when it does not.
- 25260Flexor tendon repair
- 25260 is for primary flexor tendon repair without a graft. 25265 is for secondary repair requiring a free graft.
- 25274Tendon repair
- 25274 covers secondary extensor tendon repair with a free graft. 25265 is for a flexor tendon.
- 25272Tendon repair
- 25272 is secondary extensor tendon repair without a graft; 25265 is secondary flexor tendon repair with a free graft.
25265 billing questions
When is 25265 selected instead of 25263?
Use 25265 for a secondary flexor tendon repair that uses a free graft. Code 25263 describes secondary flexor tendon repair without a graft.
Is graft harvest separately reportable?
No. The graft harvest is included in 25265.
How many units should be reported?
Report one unit for each flexor tendon repaired. The operative report should identify the tendon or tendons treated.
Should modifier 50 be used for repairs on both sides?
No. The descriptor and anatomy make modifier 50 inappropriate; report the tendon repairs rather than a bilateral procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for this procedure. 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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