No office rate
Both codes describe palsy-related tendon-transfer reconstruction, but 25315 is for radial nerve palsy; 25316 represents a different nerve-palsy pattern.
On this page
CMS RVU26D · Effective 2026-10-01
25315 Tendon transfer Medicare reimbursement rates in Rhode Island
Reports tendon-transfer reconstruction at the forearm or wrist to restore hand function lost from radial nerve palsy, including impaired wrist, finger, or thumb extension. Compare 25315 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 25315 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
$729.30
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 25315: Radial nerve palsy tendon transfer
Reports tendon-transfer reconstruction at the forearm or wrist to restore hand function lost from radial nerve palsy, including impaired wrist, finger, or thumb extension.
This operation redirects functioning tendon action to compensate for weakness caused by radial nerve palsy. The reconstructive goal is to improve lost wrist, finger, or thumb extension. An orthopedic or hand surgeon typically performs the transfer in an operating room, often as part of reconstruction for persistent functional loss after nerve injury or palsy. The operative report should identify the palsy being addressed, the tendons transferred, and the intended functional correction.
Report 25315 for the tendon-transfer procedure when the reconstruction addresses radial nerve palsy; distinguish it from transfers performed for other nerve-palsy patterns or from tendon transfers coded under the general forearm-and-wrist pathway. This major surgery 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 is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25315
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.41 · 48%
- Practice expense (office) RVU8.96 · 42%
- Malpractice RVU2.21 · 10%
15
Medicare services in 2024 · #6061 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.
25315 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
25310 is the general forearm or wrist tendon transplantation or transfer code. Choose 25315 when the transfer is the specific reconstruction for radial nerve palsy.
No office rate
25312 addresses an additional tendon in the general forearm or wrist transfer pathway; 25315 is the palsy-specific reconstruction code.
Compare 25315 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
$729.30
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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 25315 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,432
- Code
- 25315
- Physician work
- 10.41
- Practice expense
- 8.96
- Malpractice
- 2.21
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.41 | × 1.019 | 10.6078 |
| Practice expense | 8.96 | × 1.033 | 9.2557 |
| Malpractice | 2.21 | × 0.892 | 1.9713 |
| Total RVUs | 21.8348 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$729.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.41 | 1.019 |
| Practice expense | 8.96 | 1.033 |
| Malpractice | 2.21 | 0.892 |
(10.41 × 1.019 + 8.96 × 1.033 + 2.21 × 0.892) × $33.4009 = $729.30
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.
25315 billing questions
How is 25315 distinguished from 25316?
25315 addresses tendon-transfer reconstruction for radial nerve palsy. 25316 is the neighboring palsy-specific code for a different nerve-palsy pattern; use the operative diagnosis and documented reconstructive purpose to distinguish them.
When would 25310 be considered instead?
25310 describes tendon transplantation or transfer in the forearm or wrist through the general tendon-transfer pathway. Use 25315 when the procedure is specifically the palsy reconstruction represented by this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral surgery?
Yes. CMS identifies this as a bilateral procedure, with modifier 50 paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.
What documentation supports reporting 25315?
Document radial nerve palsy, the functional deficit being reconstructed, the tendons transferred, and the operative work performed. The record should make clear that the transfer addresses the radial-palsy pattern.
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.
2,42925301,,Fusion of tendons at wrist,A,,8.38,7.93,NA,7.93,,1.63,17.94,17.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43025310,,Transplant forearm tendon,A,,8.78,9.56,NA,9.56,,1.67,20.01,20.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43125312,,Transplant forearm tendon,A,,9.57,8.43,NA,8.43,,1.88,19.88,19.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43225315,,Revise palsy hand tendon(s),A,,10.41,8.96,NA,8.96,,2.21,21.58,21.58,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43325316,,Revise palsy hand tendon(s),A,,12.58,10.21,NA,10.21,,2.68,25.47,25.47,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43425320,,Repair/revise wrist joint,A,,12.43,12.93,NA,12.93,,2.41,27.77,27.77,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43525332,,Revise wrist joint,A,,11.45,9.53,NA,9.53,,2.22,23.20,23.20,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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