No office rate
25515 is for open treatment of the radial shaft without the combined closed ulnar shaft treatment included in 25525.
On this page
CMS RVU26D · Effective 2026-10-01
25525 Forearm fracture treatment Medicare reimbursement rates in Utah
Report this combined forearm fracture service when the radial shaft is treated operatively and an associated ulnar shaft fracture is treated closed. Compare 25525 office and facility rates across CMS payment localities in Utah.
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 25525 in Utah?
Utah 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
$710.35
1 of 1 localities have a supported rate.
Payment area: Utah
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 25525: Radial shaft open and ulnar shaft closed treatment
Report this combined forearm fracture service when the radial shaft is treated operatively and an associated ulnar shaft fracture is treated closed.
Code 25525 covers operative treatment of a radial shaft fracture together with closed treatment of an associated ulnar shaft fracture. An orthopedic surgeon treats the radius through an open approach, often stabilizing it with fixation, while managing the ulna without open fixation, such as with closed reduction and cast or splint immobilization when indicated. It is used when the two forearm bones receive these different treatment approaches, not when both shafts are treated operatively.
Report the combined service once; the closed ulnar treatment is included rather than separately reported. Documentation should identify both shaft fractures and describe the open radial treatment, fixation if used, and closed ulnar management. CMS assigns a 90-day major-surgery global period, including 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%. Modifier 50 pays bilateral procedures at 150%. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 25525
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.29 · 47%
- Practice expense (office) RVU9.71 · 44%
- Malpractice RVU2.06 · 9%
171
Medicare services in 2024 · #4467 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.
25525 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
25526 applies to an open radial shaft fracture with distal radioulnar joint dislocation; 25525 describes an associated ulnar shaft fracture treated closed.
No office rate
Choose 25574 when both radial and ulnar shaft fractures receive open treatment, with fixation of the radius and/or ulna, rather than closed ulnar treatment.
No office rate
25575 describes open treatment with fixation of both shafts. In 25525, the radius is treated open and the ulna closed.
Compare 25525 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
Utah →
Office / nonfacility
Unavailable
Facility
$710.35
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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 25525 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,476
- Code
- 25525
- Physician work
- 10.29
- Practice expense
- 9.71
- Malpractice
- 2.06
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.29 | × 1.000 | 10.2900 |
| Practice expense | 9.71 | × 0.940 | 9.1274 |
| Malpractice | 2.06 | × 0.898 | 1.8499 |
| Total RVUs | 21.2673 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$710.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.29 | 1 |
| Practice expense | 9.71 | 0.94 |
| Malpractice | 2.06 | 0.898 |
(10.29 × 1 + 9.71 × 0.94 + 2.06 × 0.898) × $33.4009 = $710.35
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.
25525 billing questions
When should 25525 be chosen over 25515?
Use 25525 when the radial shaft is treated operatively and an associated ulnar shaft fracture receives closed treatment as part of the service. Code 25515 describes open treatment of the radial shaft without that included ulnar treatment.
Can the ulnar shaft treatment be billed separately?
No. The closed treatment of the associated ulnar shaft fracture is included in 25525 and should not be separately reported as another fracture-treatment service.
What should the operative note support?
Document the radial and ulnar shaft fractures and the distinct approach to each: open treatment of the radius and closed management of the ulna. Include fixation details when fixation is used.
How does the 90-day global affect postoperative billing?
The global includes the day-before preoperative visit and 90 days of related postoperative care. CMS treats 25525 as major surgery with a 90-day global period.
How are bilateral procedures and additional same-session procedures handled?
CMS pays bilateral procedures reported with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%.
May an assistant or co-surgeon participate?
CMS permits payment for an assistant at surgery and permits co-surgeons for 25525. Team surgery is 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.
2,47325505,,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
2,47425515,,Optx radial shaft fracture,A,,8.58,8.66,NA,8.66,,1.74,18.98,18.98,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47525520,,Cltx rdl shft fx&dislc,A,,6.34,11.38,,8.25,,1.34,19.06,15.93,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47625525,,Optx rdl shft fx&cltx rad/ul,A,,10.29,9.71,NA,9.71,,2.06,22.06,22.06,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47725526,,Optx rdl shft fx&dstl rad/ul,A,,12.82,11.25,NA,11.25,,2.73,26.80,26.80,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47825530,,Cltx ulnar shft fx w/o mnpj,A,,2.18,6.42,,4.99,,0.44,9.04,7.61,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,47925535,,Cltx ulnar shft fx w/mnpj,A,,5.23,10.10,,7.26,,1.08,16.41,13.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985