Decompression fasciotomy of the forearm and/or wrist involving both the flexor AND extensor compartments, with debridement of nonviable muscle and/or nerve tissue.

Verified May 8, 2026 · 6 sources ↓

Medicare: $1,124.27
Total RVUs: 33.66
Global, days: 90
Region: Wrist

Drawn from CMSFindacodeAAPCAMA

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify both compartments released — flexor AND extensor — by name in the operative note; 'dual compartment' without naming them invites downcoding to 25020.
Document clinical findings supporting compartment syndrome: measured compartment pressures, neurovascular exam findings, mechanism of injury or underlying cause.
Describe debridement in detail: location, extent of nonviable muscle and/or nerve tissue removed, method of excision — this is what separates 25025 from 25024.
Record laterality explicitly (left vs. right forearm) in both the operative note and the procedure order.
If returning to OR postoperatively, document whether the indication is related to the original procedure (modifier 78) or unrelated (modifier 79).
For modifier 22, provide a separate written justification of increased complexity with quantified additional time or unique anatomic challenges.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 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 6 cited references ↓

25025 covers a two-compartment forearm fasciotomy — flexor and extensor — where the surgeon opens the fascia to relieve pathologically elevated compartment pressure and goes further to excise nonviable muscle and/or nerve tissue. That debridement step is the critical distinction from 25024, which covers the same dual-compartment release without tissue removal. If you're only releasing one compartment (flexor OR extensor), you're in the 25020/25023 family, not here.

25025 carries a 90-day global period. All routine post-op management, wound checks, and dressing changes through day 90 are bundled. Per AAOS Global Service Data, 25025 includes 25024, 25020, 20520, 20525, 25248, 25000, 64719, and 64721 — bill any of those on the same date and expect a bundle edit. Compartment syndrome is the classic indication; ICD-10 alignment (traumatic vs. nontraumatic etiology) is a common denial trigger.

This procedure is performed in both hospital outpatient and ASC settings. Site of service affects reimbursement materially — see the Site of Service comparison table on this page. Modifier LT or RT is required by most payers to specify laterality. If both forearms are decompressed in the same session, append modifier 50 and confirm your payer's bilateral payment policy before submitting.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	17.49
Practice expense RVU	12.45
Malpractice RVU	3.72
Total RVU	33.66
Medicare national rate	$1,124.27
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	$1,124.27
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 25025 get rejected.

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

Downcoding to 25024 or 25020 when operative note fails to document tissue debridement or does not specify both compartments by name.
ICD-10 mismatch — traumatic compartment syndrome codes vs. nontraumatic codes must align with the documented etiology; payers audit this pairing closely.
Missing or incorrect laterality modifier; many payers auto-deny forearm procedures submitted without LT or RT.
Unbundling denial when 25024, 25020, 25248, 64719, or 64721 are billed on the same date — all are included per AAOS bundling guidance.
Global period violation when post-op visits or related procedures are billed during the 90-day global without the appropriate modifier 24, 78, or 79.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between 25025 and 25024?

Both cover dual-compartment (flexor AND extensor) forearm fasciotomy. 25025 requires debridement of nonviable muscle and/or nerve tissue; 25024 does not. If debridement occurred, 25025 is correct — do not bill both. AAOS bundling guidance lists 25024 as included in 25025.

02When do I use 25025 versus 25020 or 25023?

25020 and 25023 cover release of a single compartment (flexor OR extensor). 25025 requires both compartments to be released AND debridement performed. If only one compartment was addressed, use the 25020 family regardless of whether debridement occurred.

03Is modifier 50 appropriate if both forearms are decompressed in the same session?

Yes. Append modifier 50 when the identical procedure is performed bilaterally in the same operative session. Confirm your payer's bilateral reduction policy — Medicare typically pays 150% of the single-procedure allowable, but commercial payers vary.

04Which codes are bundled into 25025 and cannot be billed separately on the same date?

Per AAOS Global Service Data, 25025 includes 25024, 25020, 20520, 20525, 25248, 25000, 64719, and 64721. Billing any of these alongside 25025 on the same date will generate a bundle edit regardless of modifier.

05What modifier is needed to bill a related return to the OR during the 90-day global?

Use modifier 78 for an unplanned return to the operating room for a procedure related to the original fasciotomy during the 90-day global period. Use modifier 79 only if the return procedure is unrelated to the original. Do not invert these — payers distinguish them and will deny the wrong one.

06Does 25025 require a laterality modifier?

Most payers, including Medicare, require LT or RT on forearm procedures. Omitting laterality is a common clean-claim failure. If bilateral, use modifier 50 instead of separate LT/RT line items unless your payer specifically requires two lines.

07Can I bill an E/M on the same day as 25025 for a new, unrelated problem addressed during the encounter?

Yes, but only with modifier 25 appended to the E/M code, and only if the E/M service is significant, separately identifiable, and documented independently from the pre-procedure assessment. The AMA and CMS both require documentation that the E/M work could stand alone as a reportable service.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures compartment pressure measurements, the specific fascial compartments released (flexor and extensor), the description and extent of nonviable muscle and/or nerve tissue debrided, neurovascular findings, and laterality — all from your dictation. That documentation directly defends the upgrade from 25024 to 25025 and preempts the most common audit flag: an operative note that documents the fasciotomy but omits the debridement findings that justify the higher-complexity code.

See how Mira captures CPT 25025 documentation