Secondary closure or scar revision of a transhumeral amputation stump, performed after the original amputation has already been completed.

Verified May 8, 2026 · 8 sources ↓

Medicare: $545.44
Work RVU: 7.12
Global, days: 90
Region: Elbow

Drawn from CMSAAPCFindacodeMdclarityEmedny

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 8 cited references ↓

Specify this is a secondary closure or scar revision — not a re-amputation (24930) or stump elongation (24935)
Document the indication: inadequate primary closure, open guillotine wound requiring delayed closure, or symptomatic scar contracture
Identify the anatomic level: through the humerus (transhumeral), confirming upper arm involvement
Note relationship to prior amputation: date of original procedure, original CPT code, and whether this is a planned staged procedure or response to a complication
Operative note must name the specific technique used for revision — audit teams flag notes that only reference 'stump revision' without describing the approach and tissue layers involved
If modifier 22 is appended, document the factors that increased complexity beyond typical revision work

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

CPT 24925 covers a return trip to the OR to revise a transhumeral (arm through humerus) amputation stump — specifically for secondary closure or scar revision. The original amputation was performed under a different code (24900, 24920, or 24930); 24925 is the follow-up surgical procedure when the initial wound closure was inadequate, left open intentionally (guillotine), or resulted in a painful or dysfunctional scar that requires formal revision.

Carries a 90-day global period under CMS Physician Fee Schedule 2026. That means the day before surgery, the procedure itself, and all routine post-op care through day 90 are bundled. Any E/M visit for an unrelated problem during that window requires modifier 24. A separately identifiable E/M on the day of surgery requires modifier 25.

This code is inherently a staged or follow-up procedure. If you're billing 24925 after a recent 24920 (open guillotine amputation) by the same surgeon, append modifier 58 to signal a planned staged procedure — not modifier 78, which is reserved for unplanned returns to the OR for a complication of the prior surgery.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (7.12) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.33) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.12
Practice expense RVU	7.71
Malpractice RVU	1.5
Total RVU	16.33
Medicare national rate	$545.44
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$545.44
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 24925 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or mismatched diagnosis code — ICD-10 must reflect acquired absence of upper limb with a complication, scar, or incomplete healing rather than a generic amputation status code
Modifier 58 omitted when billing 24925 within the global period of 24920 by the same surgeon — payer reads it as a duplicate or global-period violation
Modifier 78 incorrectly applied instead of 58 for a planned staged closure after guillotine amputation — 78 is for unplanned returns, not staged procedures
Insufficient operative documentation: notes that don't distinguish secondary closure from re-amputation (24930) or scar revision from stump elongation (24935) trigger downcoding or denial
Global period overlap when a different surgeon performs 24925 and fails to append modifier 79 if the procedure is unrelated to the original surgeon's global period

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01What is the difference between CPT 24925 and CPT 24930?

24925 is secondary closure or scar revision — the stump level stays the same, and the goal is wound closure or scar improvement. 24930 is re-amputation, meaning the limb is shortened to a more proximal level. Use the operative plan and findings to determine which code applies; billing 24925 when bone was resected at a new level will be denied or flagged on audit.

02If I performed a guillotine amputation (24920) and now I'm closing the stump, which modifier do I use on 24925?

Modifier 58 — staged or related procedure by the same physician during the post-op period. A delayed closure after an open guillotine amputation is, by definition, a planned staged procedure. Modifier 78 applies only to unplanned returns to the OR for a complication, not to an anticipated second-stage closure.

03Does CPT 24925 carry a global period, and what does that include?

Yes — 24925 has a 90-day global period under CMS Physician Fee Schedule 2026. That bundles the day-before visit, the operative session, and all routine post-op care through day 90. Bill modifier 24 for unrelated E/M visits and modifier 25 for a separately identifiable E/M on the day of surgery.

04Can 24925 be billed bilaterally?

Bilateral transhumeral amputation stump revision is anatomically possible but rare. If performed bilaterally in the same session, append modifier 50. Document both sides explicitly in the operative note; a single-side note with modifier 50 attached will be denied.

05What ICD-10 codes pair with CPT 24925?

You need a code that reflects an acquired absence of the upper limb (Z89 category) combined with a complication or condition driving the revision — such as painful or adherent scar, wound dehiscence, or delayed healing. A bare Z89 code without a complication diagnosis is insufficient and is a common reason for denial.

06When is modifier 22 appropriate for CPT 24925?

Append modifier 22 when the revision required substantially more work than a typical secondary closure — for example, extensive infection requiring debridement, severe scar contracture with complex tissue mobilization, or significantly altered anatomy from prior trauma or radiation. The documentation must quantify what made the case unusual; modifier 22 without supporting operative detail will be stripped by the payer.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the surgical indication (wound dehiscence, open guillotine stump requiring delayed closure, or scar contracture), the anatomic level through the humerus, the tissue layers involved in the revision, and the relationship to the prior amputation procedure and date. That documentation directly supports modifier 58 for staged procedures and prevents denials that stem from underdocumented operative notes that fail to distinguish secondary closure from re-amputation.

See how Mira captures CPT 24925 documentation