Billing code 25405: Forearm bone repairMedicare rate & RVUs in Oregon
Corrects a radius or ulna nonunion or malunion using the patient's own bone graft to support healing of the repaired forearm bone.
CMS doesn’t publish an office rate for 25405 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 25405 covers
This operation treats a radius or ulna that has failed to heal or has healed in a problematic position. The orthopedic or hand surgeon exposes the affected bone, corrects its alignment or prepares the nonunion, adds bone graft taken from the patient, and stabilizes the repair. It is generally performed in an operating room, often in a hospital or ambulatory surgery setting.
Report this code when one forearm bone is repaired with autograft; the graft harvest is included. Document which bone and side were treated, the nonunion or malunion, and the use of the patient's own graft. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies bilateral work and is paid at 150%. An assistant at surgery may be paid; 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.
Where 25405 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $961.89 |
| Rest Of Oregon | Unavailable | $909.34 |
How the 25405 rate is calculated
Each of 25405’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 · 25405
RVUs × geographic indexes × conversion factor
Work14.63
14.63 RVUs× 1.000 GPCI
Practice expense10.62
10.62 RVUs× 1.000 GPCI
Malpractice2.87
2.87 RVUs× 1.000 GPCI
Adjusted RVUs
28.1200
Conversion factor
$33.4009
Medicare rate
$939.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25405
25405 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25405
Forearm bone 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 · 25405
Forearm bone 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
25405 without 50 · national facility
$939.23
Forearm bone repair
25405-50 · Bilateral: 150%
$1,408.85
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).
25405 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25400Forearm bone repair
- Choose 25400 for a one-bone repair without graft; 25405 includes the patient's own bone graft.
- 25420Forearm repair
- 25420 is for repair of both the radius and ulna with autograft. 25405 is for one of those bones.
- 25425Forearm bone repair
- Both codes address a single-bone forearm repair with graft, but 25425 uses allograft rather than the patient's own bone.
25405 billing questions
How does 25405 differ from 25400?
25405 applies when the repair uses the patient's own bone graft. Use 25400 for the corresponding single-bone repair without graft.
Can the graft harvest be billed separately?
No. Obtaining the autograft is included in this repair.
Does 25405 cover repair of both forearm bones?
No. It covers the radius or the ulna. For repair of both bones with autograft, compare 25420.
When is modifier 50 appropriate?
Use modifier 50 when the repair is performed bilaterally. CMS pays the bilateral procedure at 150%.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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