No office rate
Choose 25035 for cortical access to infected forearm or wrist bone. Choose 25028 when drainage is directed at a deep soft-tissue abscess or hematoma.
On this page
CMS RVU26D · Effective 2026-10-01
25035 Bone incision Medicare reimbursement rates in South Dakota
Opening the cortex of a forearm or wrist bone provides surgical access to infected bone, such as in osteomyelitis or a bone abscess. Compare 25035 office and facility rates across CMS payment localities in South Dakota.
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 25035 in South Dakota?
South Dakota 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
$528.21
1 of 1 localities have a supported rate.
Payment area: South Dakota**
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 25035: Forearm or wrist bone cortex incision
Opening the cortex of a forearm or wrist bone provides surgical access to infected bone, such as in osteomyelitis or a bone abscess.
This operation opens the outer layer of a forearm or wrist bone to reach an infected area, such as osteomyelitis or a bone abscess, for drainage or debridement. An orthopedic surgeon typically performs it in a hospital or ambulatory surgery setting. The target is bone, not an abscess limited to soft tissue, a bursa, or a wrist joint.
Report the code when the operative work includes an incision through the bone cortex; document the affected bone, side, indication, and the work performed. It 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 procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25035
- 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 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 RVU7.46 · 44%
- Practice expense (office) RVU7.82 · 46%
- Malpractice RVU1.59 · 9%
105
Medicare services in 2024 · #4841 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.
25035 compared with similar codes
Office rates for South Dakota, from the same CMS release.
No office rate
25031 is directed at a forearm or wrist bursa; 25035 is directed at bone cortex.
No office rate
25040 describes an operation on the wrist or midcarpal joint. Use 25035 when the operative target is forearm or wrist bone.
Compare 25035 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
South Dakota** →
Office / nonfacility
Unavailable
Facility
$528.21
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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 25035 in South Dakota**.
PPRRVU2026_Oct_nonQPP.csv
2,376
- Code
- 25035
- Physician work
- 7.46
- Practice expense
- 7.82
- Malpractice
- 1.59
GPCI2026.csv
94
- Locality
- South Dakota**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.46 | × 1.000 | 7.4600 |
| Practice expense | 7.82 | × 1.000 | 7.8200 |
| Malpractice | 1.59 | × 0.336 | 0.5342 |
| Total RVUs | 15.8142 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, South Dakota**$528.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.46 | 1 |
| Practice expense | 7.82 | 1 |
| Malpractice | 1.59 | 0.336 |
(7.46 × 1 + 7.82 × 1 + 1.59 × 0.336) × $33.4009 = $528.21
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.
25035 billing questions
When is this code preferable to a deep forearm or wrist abscess drainage code?
Use this code when the surgeon opens the bone cortex to address infected bone. A deep soft-tissue abscess without bone work points to a soft-tissue drainage code instead.
Does it describe drainage of a wrist joint or bursa?
No. The target is bone cortex; a procedure directed at the wrist joint or a bursa is coded according to that structure and the work performed.
What documentation supports reporting it?
Document the affected forearm or wrist bone, laterality, the bone infection or abscess being treated, and the cortical incision and work performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is it paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of 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.
2,37325025,,Decompress forearm 2 spaces,A,,17.49,12.45,NA,12.45,,3.72,33.66,33.66,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37425028,,I&d f/arm&/wrst dp absc/hmtm,A,,5.26,14.27,NA,14.27,,1.07,20.60,20.60,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37525031,,I&d forearm&/wrist bursa,A,,4.15,5.86,NA,5.86,,0.89,10.90,10.90,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37625035,,Inc dp bone crtx f/arm&/wrst,A,,7.46,7.82,NA,7.82,,1.59,16.87,16.87,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37725040,,Arthrt rdcrpl/midcarpl jt,A,,7.31,6.95,NA,6.95,,1.45,15.71,15.71,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37825065,,Biopsy forearm soft tissues,A,,1.99,5.57,,2.10,,0.28,7.84,4.37,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37925066,,Biopsy forearm soft tissues,A,,4.16,5.75,NA,5.75,,0.82,10.73,10.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929