$282.77
Both describe closed treatment of an ulnar shaft fracture. Choose 25535 when manipulation is performed; choose 25530 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
25535 Fracture treatment Medicare reimbursement rates in Wisconsin
Reports closed reduction of an ulnar shaft fracture when the physician manipulates the bone to improve alignment without open surgery. Compare 25535 office and facility rates across CMS payment localities in Wisconsin.
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 25535 in Wisconsin?
Wisconsin 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
$508.98
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$418.10
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 fracture care
About 25535: Closed ulnar shaft fracture reduction
Reports closed reduction of an ulnar shaft fracture when the physician manipulates the bone to improve alignment without open surgery.
An orthopedic surgeon or other qualified physician reports this service for closed treatment of an ulnar shaft fracture that requires manipulation to restore alignment. The reduction is performed without surgically exposing the fracture; immobilization may follow. Typical settings include an emergency department, clinic, or hospital, depending on where the fracture is treated.
Select this code when documentation supports manipulation of the ulnar shaft fracture, rather than treatment without manipulation or open fixation. Record the fracture site, reduction performed, and treatment plan. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25535
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.23 · 32%
- Practice expense (office) RVU10.10 · 62%
- Malpractice RVU1.08 · 7%
381
Medicare services in 2024 · #3775 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.
25535 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
25545 describes open treatment with internal fixation. This code is for closed reduction by manipulation without open fixation.
$546.80
25505 applies to a radial shaft fracture treated closed with manipulation; 25535 applies to the ulnar shaft.
$576.96
25565 describes closed treatment with manipulation of fractures involving both the radial and ulnar shafts, rather than an ulnar shaft fracture alone.
Compare 25535 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
Wisconsin →
Office / nonfacility
$508.98
Facility
$418.10
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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 25535 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
2,479
- Code
- 25535
- Physician work
- 5.23
- Practice expense
- 10.10
- Malpractice
- 1.08
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.23 | × 1.000 | 5.2300 |
| Practice expense | 10.10 | × 0.958 | 9.6758 |
| Malpractice | 1.08 | × 0.308 | 0.3326 |
| Total RVUs | 15.2384 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$508.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.23 | 1 |
| Practice expense | 10.1 | 0.958 |
| Malpractice | 1.08 | 0.308 |
(5.23 × 1 + 10.1 × 0.958 + 1.08 × 0.308) × $33.4009 = $508.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.23 | 1 |
| Practice expense | 7.26 | 0.958 |
| Malpractice | 1.08 | 0.308 |
(5.23 × 1 + 7.26 × 0.958 + 1.08 × 0.308) × $33.4009 = $418.10
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.
25535 billing questions
How does this differ from 25530?
Use 25535 when the physician manipulates the ulnar shaft fracture to improve alignment. Code 25530 describes closed treatment without manipulation.
When is 25545 more appropriate?
Code 25545 is for open treatment of an ulnar shaft fracture with internal fixation. This code describes closed treatment with manipulation, without open fixation.
What documentation supports reporting 25535?
Document the ulnar shaft fracture, the manipulation or reduction performed, and the treatment plan. The record should distinguish the service from treatment without manipulation.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS applies that period to this fracture treatment.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How are bilateral treatment and multiple procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the 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.
2,47625525,,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
2,48025545,,Optx ulnar shft fx int fixj,A,,7.74,8.51,NA,8.51,,1.56,17.81,17.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48125560,,Cltx rdl&uln shft fx wo mnpj,A,,2.53,6.90,,5.15,,0.51,9.94,8.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48225565,,Cltx rdl&uln shft fx w/mnpj,A,,5.70,11.66,,8.25,,1.31,18.67,15.26,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,