No office rate
Both concern extensor structures in the forearm or wrist. Choose 25270 for a primary repair and 25272 for a secondary repair.
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CMS RVU26D · Effective 2026-10-01
25272 Tendon repair Medicare reimbursement rates in Rhode Island
Reports secondary repair of a single extensor tendon or muscle in the forearm or wrist, such as delayed reconstruction after an earlier injury. Compare 25272 office and facility rates across CMS payment localities in Rhode Island.
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 25272 in Rhode Island?
Rhode Island 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
No supported rate
Facility setting
$543.17
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Hand surgery
About 25272: Secondary extensor tendon repair
Reports secondary repair of a single extensor tendon or muscle in the forearm or wrist, such as delayed reconstruction after an earlier injury.
This service covers secondary repair of one extensor tendon or muscle in the forearm or wrist. It is typically performed by an orthopedic, plastic, or hand surgeon when an extensor structure needs repair after the primary repair opportunity, including delayed treatment of an injury. The operative report should identify the structure and site and explain the secondary nature of the repair.
Select this code for one extensor tendon or muscle when the surgeon documents a secondary repair, rather than a primary repair or repair of a flexor structure. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25272
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.03 · 44%
- Practice expense (office) RVU7.53 · 47%
- Malpractice RVU1.48 · 9%
121
Medicare services in 2024 · #4732 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.
25272 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
This is the secondary-repair counterpart for a flexor tendon or muscle; 25272 is for an extensor structure.
No office rate
25274 is for an additional tendon or muscle in the primary extensor-repair series; 25272 describes secondary repair.
Compare 25272 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$543.17
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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 25272 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,422
- Code
- 25272
- Physician work
- 7.03
- Practice expense
- 7.53
- Malpractice
- 1.48
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.03 | × 1.019 | 7.1636 |
| Practice expense | 7.53 | × 1.033 | 7.7785 |
| Malpractice | 1.48 | × 0.892 | 1.3202 |
| Total RVUs | 16.2622 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$543.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.03 | 1.019 |
| Practice expense | 7.53 | 1.033 |
| Malpractice | 1.48 | 0.892 |
(7.03 × 1.019 + 7.53 × 1.033 + 1.48 × 0.892) × $33.4009 = $543.17
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.
25272 billing questions
How does this differ from 25270?
25270 is for primary repair of an extensor tendon or muscle in the forearm or wrist. Use 25272 when the documented repair is secondary.
How does this differ from 25263?
25263 describes secondary repair of a flexor tendon or muscle. This code is for an extensor structure.
What documentation supports secondary repair?
Document the repaired tendon or muscle, its forearm or wrist location, and why the procedure is secondary rather than primary.
Does the global period include postoperative visits?
Yes. The 90-day global period includes related postoperative care and the preoperative visit on the day before surgery.
Can modifier 50 be reported?
No. Bilateral adjustment is inappropriate for this code.
When is assistant-at-surgery payment allowed?
Only when the record documents 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 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.
2,41925263,,Repair forearm tendon/muscle,A,,7.84,8.69,NA,8.69,,1.67,18.20,18.20,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42025265,,Repair forearm tendon/muscle,A,,9.85,8.91,NA,8.91,,1.84,20.60,20.60,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42125270,,Repair forearm tendon/muscle,A,,6.02,6.89,NA,6.89,,1.19,14.10,14.10,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42225272,,Repair forearm tendon/muscle,A,,7.03,7.53,NA,7.53,,1.48,16.04,16.04,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42325274,,Repair forearm tendon/muscle,A,,8.72,8.08,NA,8.08,,1.64,18.44,18.44,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42425275,,Repair forearm tendon sheath,A,,8.74,8.28,NA,8.28,,1.66,18.68,18.68,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42525280,,Revise wrist/forearm tendon,A,,7.21,7.32,NA,7.32,,1.41,15.94,15.94,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537