Billing code 25390: Bone shorteningMedicare rate & RVUs in Washington
Reports operative shortening of the radius or ulna, commonly to correct forearm bone-length mismatch contributing to wrist pain or impaired joint mechanics.
CMS doesn’t publish an office rate for 25390 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 25390 covers
This operation shortens one forearm bone by removing bone and correcting its length, with stabilization as needed. Orthopedic and hand surgeons commonly perform it in an operating room. A familiar indication is ulnar impaction, in which the ulna is relatively long and overloads the wrist; the surgeon selects the bone and correction based on the patient’s anatomy and treatment plan.
Report 25390 when the operative work shortens either the radius or the ulna; use the both-bone code when both are shortened. The operative report should identify the bone and side, the reason for shortening, and the procedure performed. Medicare assigns 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 are subject to the standard 50% reduction. Modifier 50 applies to bilateral procedures, paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
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.
Where 25390 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $708.67 |
| Seattle (King Cnty) | Unavailable | $775.69 |
How the 25390 rate is calculated
Each of 25390’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 25390
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.43Practice expense 8.67Malpractice 2.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25390
25390 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25390
Bone shortening
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25390
Bone shortening
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25390 without 50 · national facility
$704.76
Bone shortening
25390-50 · Bilateral: 150%
$1,057.14
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
25390 compared with similar codes
Compare codes
25390 vs 25391 vs 25392 vs 25393: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25391Bone lengthening
- Choose 25390 for shortening one forearm bone. Choose 25391 when one bone is surgically lengthened.
- 25392Forearm osteotomy
- 25390 covers shortening either the radius or ulna; 25392 is for shortening both bones.
- 25393Forearm lengthening
- 25390 describes shortening one bone. 25393 describes lengthening both the radius and ulna.
25390 billing questions
When is 25390 used instead of 25392?
Use 25390 when the surgeon shortens either the radius or the ulna. Code 25392 describes shortening both bones.
How does 25390 differ from 25391?
25390 is for shortening one forearm bone; 25391 is for lengthening one. The operative direction of the bone correction distinguishes them.
Can modifier 50 be reported for bilateral shortening?
Yes. CMS identifies this as a bilateral procedure, with modifier 50 paid at 150%.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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