No office rate
Use 25490 when prophylactic stabilization is performed on the radius. This code is specific to the ulna.
On this page
CMS RVU26D · Effective 2026-10-01
25491 Bone stabilization Medicare reimbursement rates in Rhode Island
Reports operative stabilization of an ulna weakened and at risk for fracture, such as from destructive bone disease, before a fracture occurs. Compare 25491 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 25491 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
$703.10
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.
Orthopedic surgery
About 25491: Prophylactic ulna stabilization
Reports operative stabilization of an ulna weakened and at risk for fracture, such as from destructive bone disease, before a fracture occurs.
An orthopedic surgeon stabilizes the ulna before it breaks when disease or bone damage has made it vulnerable to fracture. The operation may use internal fixation such as a plate, pins, wires, or a nail; bone cement may also be used. A typical clinical setting is an operating room, with a destructive lesion, including one related to metastatic disease, creating concern for an impending fracture.
Choose this code when the operative goal is to prevent an ulna fracture, rather than to repair an existing fracture or a healing problem. The record should identify the ulna treated, the condition weakening the bone, the fracture risk, and the stabilization performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one 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 services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25491
- 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 RVU9.90 · 48%
- Practice expense (office) RVU8.79 · 42%
- Malpractice RVU2.11 · 10%
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.
25491 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Use 25492 when both radius and ulna receive prophylactic treatment; 25491 identifies treatment of the ulna alone.
No office rate
25400 describes repair of an established radius or ulna healing problem. Choose 25491 when the operation is intended to prevent a fracture.
No office rate
25405 is for repair of a radius or ulna healing problem with grafting, not prophylactic stabilization of an at-risk ulna.
Compare 25491 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
$703.10
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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 25491 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,470
- Code
- 25491
- Physician work
- 9.90
- Practice expense
- 8.79
- Malpractice
- 2.11
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.90 | × 1.019 | 10.0881 |
| Practice expense | 8.79 | × 1.033 | 9.0801 |
| Malpractice | 2.11 | × 0.892 | 1.8821 |
| Total RVUs | 21.0503 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$703.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.9 | 1.019 |
| Practice expense | 8.79 | 1.033 |
| Malpractice | 2.11 | 0.892 |
(9.9 × 1.019 + 8.79 × 1.033 + 2.11 × 0.892) × $33.4009 = $703.10
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.
25491 billing questions
How does 25491 differ from 25490 and 25492?
25491 is for prophylactic stabilization of the ulna. Code 25490 is for the radius, while 25492 covers both the radius and ulna.
Can 25491 be used when the ulna is already fractured?
This code describes stabilization intended to prevent a fracture. When surgery repairs an established fracture or a nonunion, select the code that describes that repair instead.
What documentation supports reporting 25491?
Document the affected ulna, the bone-weakening condition, why fracture prevention is needed, and the fixation or other stabilization performed.
Does the 90-day global period include postoperative care?
Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported with 25491?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
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.
2,46725450,,Epiphysl arrst dstl rds/ulna,A,,7.86,8.14,NA,8.14,,1.67,17.67,17.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46825455,,Epiphysl arrst dstl rds&ulna,A,,9.47,9.21,NA,9.21,,2.02,20.70,20.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46925490,,Prophylactic tx radius,A,,9.49,8.81,NA,8.81,,2.02,20.32,20.32,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47025491,,Prophylactic tx ulna,A,,9.90,8.79,NA,8.79,,2.11,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47125492,,Prophylactic tx radius&ulna,A,,12.34,10.29,NA,10.29,,2.62,25.25,25.25,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47225500,,Cltx rdl shft fx w/o mnpj,A,,2.54,6.73,,5.12,,0.51,9.78,8.17,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47325505,,Cltx rdl shft fx w/mnpj,A,,5.31,11.16,,8.18,,1.20,17.67,14.69,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,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