No office rate
Both are open fixation codes for intra-articular distal radius fractures. The fragment count distinguishes them: 25608 is for two fragments, while 25609 is for three or more.
On this page
CMS RVU26D · Effective 2026-10-01
25609 Distal radius fixation Medicare reimbursement rates in Rhode Island
Report 25609 for open reduction and fixation of a distal radius fracture involving the joint surface with three or more fragments. Compare 25609 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 25609 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
$980.74
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 25609: Open fixation of complex intra-articular distal radius fracture
Report 25609 for open reduction and fixation of a distal radius fracture involving the joint surface with three or more fragments.
This service involves surgically exposing a distal radius fracture, restoring alignment of the joint surface, and stabilizing the fracture with fixation. It is typically performed by an orthopedic or hand surgeon for a complex, comminuted fracture that extends into the wrist joint. The procedure is commonly performed in a hospital operating room or ambulatory surgery center.
Choose this code when the fracture is intra-articular and has three or more fragments; the operative report should establish joint involvement, fragment count, open treatment, and fixation performed. Reduction and fixation are part of the service, not separate procedures. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 25609
- 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 RVU14.02 · 48%
- Practice expense (office) RVU12.22 · 42%
- Malpractice RVU2.75 · 9%
30.7K
Medicare services in 2024 · #967 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.
25609 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
25607 applies to an extra-articular distal radius fracture treated openly. Use 25609 for an intra-articular fracture with three or more fragments.
No office rate
25606 describes percutaneous skeletal fixation of a distal radius fracture. 25609 describes open treatment of an intra-articular fracture with three or more fragments.
$646.26
25605 is closed treatment with manipulation, rather than open reduction and fixation. Choose based on the treatment actually performed.
Compare 25609 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
$980.74
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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 25609 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,490
- Code
- 25609
- Physician work
- 14.02
- Practice expense
- 12.22
- Malpractice
- 2.75
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.02 | × 1.019 | 14.2864 |
| Practice expense | 12.22 | × 1.033 | 12.6233 |
| Malpractice | 2.75 | × 0.892 | 2.4530 |
| Total RVUs | 29.3626 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$980.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.02 | 1.019 |
| Practice expense | 12.22 | 1.033 |
| Malpractice | 2.75 | 0.892 |
(14.02 × 1.019 + 12.22 × 1.033 + 2.75 × 0.892) × $33.4009 = $980.74
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.
25609 billing questions
How is 25609 different from 25608?
Both describe open treatment of an intra-articular distal radius fracture with fixation. Use 25609 when there are three or more fragments; 25608 is for two fragments.
When should 25607 be reported instead?
25607 is for open treatment of an extra-articular distal radius fracture. The fracture treated with 25609 must extend into the wrist joint and involve three or more fragments.
Can reduction or fixation be billed separately?
No. The open reduction and fixation are included in 25609; document the fracture pattern and operative work supporting the code.
What documentation supports 25609?
The operative report should identify intra-articular extension, establish that three or more fragments are involved, and describe the open treatment and fixation.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral procedures or other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%.
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.
2,48725606,,Perq skel fixj dstl rdl fx,A,,8.10,9.42,NA,9.42,,1.69,19.21,19.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48825607,,Optx dst rd xartc fx/epi sep,A,,9.32,9.68,NA,9.68,,1.88,20.88,20.88,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48925608,,Optx dst rd xart fx/epi sep2,A,,10.79,10.15,NA,10.15,,2.17,23.11,23.11,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49025609,,Optx dst rd xart fx/ep sep3+,A,,14.02,12.22,NA,12.22,,2.75,28.99,28.99,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49125622,,Cltx carpl scphd fx w/o mnpj,A,,2.72,7.24,,5.60,,0.54,10.50,8.86,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49225624,,Cltx carpl scphd fx w/mnpj,A,,4.65,10.79,,7.71,,1.00,16.44,13.36,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49325628,,Optx carpl scphd fx int fixj,A,,9.43,8.80,NA,8.80,,1.80,20.03,20.03,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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