Decompression fasciotomy of the forearm releasing both the flexor and extensor compartments through surgical incision to relieve pathologically elevated intracompartmental pressure.
Verified May 8, 2026 · 4 sources ↓
- Medicare
- $726.80
- Total RVUs
- 21.76
- Global, days
- 90
- Region
- Wrist
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 4 cited references ↓
- Specify both compartments released by name (flexor AND extensor) — a note documenting only one compartment release supports 25020, not 25024.
- Document the clinical indication with measured or estimated intracompartmental pressures where available, or describe the clinical signs and urgency driving the decision to operate.
- Record the surgical approach, incision length and location, fascial incision extent, and whether the skin was left open or primarily closed.
- If delayed closure or skin grafting is planned at a separate operative session, document that plan explicitly in the operative note to support modifier 58 on the return visit.
- Capture neurovascular status pre- and post-decompression, including motor and sensory exam findings of the median, ulnar, and radial nerves.
- Note laterality (left or right forearm) in both the operative report and the claim.
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 4 cited references ↓
CPT 25024 describes a forearm fasciotomy in which the surgeon incises the fascia of both the flexor and extensor compartments to decompress acutely elevated pressure threatening neurovascular integrity and muscle viability. This is the two-compartment code — if only one compartment is released, that work maps to 25020, not 25024. The distinction is not minor; auditors routinely flag upcoding when the operative note documents a single-compartment release but 25024 is billed.
The procedure is most often performed urgently for acute compartment syndrome of the forearm — post-fracture, crush injury, reperfusion, or prolonged compression — and occasionally for chronic exertional compartment syndrome refractory to conservative management. The 90-day global period applies, covering all routine post-op visits, wound checks, and secondary closure planning through day 90. Delayed primary closure or skin grafting performed after the index fasciotomy requires modifier 58 (staged procedure) if planned, or modifier 78 (unplanned return to OR for a related procedure) if not.
Site of service matters significantly here. HOPD and ASC payments differ substantially — see the Site of Service comparison table. Because this is typically an urgent or emergent case, verify whether the patient presentation supports emergency department or inpatient service codes billed on the same date, and apply modifier 25 to any separately documented E&M if it occurred on the same day as the procedure.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 10.52 |
| Practice expense RVU | 9.05 |
| Malpractice RVU | 2.19 |
| Total RVU | 21.76 |
| Medicare national rate | $726.80 |
| 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 | $726.80 |
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 25024 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billing 25024 when the operative note documents release of only one compartment — payers downcode to 25020 or deny outright.
- Missing or inadequate clinical justification for emergent fasciotomy — no documented pressure measurements, neuro deficits, or tense compartment findings.
- Modifier 58 omitted on a staged wound closure or skin graft billed within the 90-day global period, causing the return OR visit to deny as included in the global.
- Laterality not specified on the claim when bilateral release was performed — without modifiers LT and RT or 50, one side denies.
- E&M billed same-day without modifier 25, resulting in denial of the office or ED visit as bundled into the surgical package.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01What is the difference between CPT 25020 and 25024?
02Can delayed primary closure of the fasciotomy wound be billed separately?
03Does the 90-day global apply even for urgent or emergent fasciotomies?
04How should bilateral forearm fasciotomies be billed?
05Is modifier 22 appropriate for an unusually extensive forearm fasciotomy?
06Can an E&M be billed on the same date as 25024?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira AI Scribe
Mira's AI scribe captures both compartment releases by name from dictation — flexor and extensor — along with documented clinical indications, intracompartmental pressure values, incision details, and post-decompression neurovascular findings. This prevents the most common denial trigger: a note that describes single-compartment release being billed under the two-compartment code 25024. The scribe also flags open wound status and auto-prompts for modifier 58 documentation if staged closure is planned.
See how Mira captures CPT 25024 documentation