Partial excision of the radius bone, including craterization, saucerization, or diaphysectomy — typically performed for osteomyelitis or bone lesions of the forearm.

Verified May 8, 2026 · 6 sources ↓

Medicare: $545.77
Work RVU: 7.49
Global, days: 90
Region: Wrist

Drawn from CMSNIHAAPCMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must name the specific technique used: craterization, saucerization, or diaphysectomy — not just 'bone excision' or 'standard approach'.
Identify the pathology driving the procedure (e.g., osteomyelitis, cyst, tumor) and tie it to the supporting diagnosis code.
Document the extent of bone removed, including anatomic location on the radius (proximal, mid-shaft, distal) and approximate dimensions or percentage of cortex involved.
If modifier 22 is appended, the operative note must explicitly describe what made the case substantially more complex than typical — prior infection, hardware removal, or unusual anatomy.
Record pre-operative imaging (X-ray, MRI, or bone scan) that confirms the pathologic finding and supports medical necessity.
Note wound management at closure: primary closure, open packing, drain placement, or planned staged closure, as relevant to post-op billing within the global period.

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 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 25151 covers surgical removal of a portion of the radius — the lateral forearm bone — using techniques such as craterization (scooping out infected or diseased bone), saucerization (creating a shallow dish-shaped defect to promote drainage and healing), or diaphysectomy (resecting a segment of the bone shaft). The procedure is most commonly indicated for osteomyelitis, benign bone tumors, cysts, or other focal pathology compromising radial bone integrity. It is distinct from 25150, which addresses partial excision of the ulna.

This code carries a 90-day global period. All routine post-op visits, wound checks, and dressing changes through day 90 are bundled. Any E&M service during the global period that addresses a new or unrelated problem requires modifier 24. A separate E&M on the day of surgery for a distinct, significant decision requires modifier 25 appended to the E&M — not to the surgical code.

When the procedure is performed bilaterally (rare, but possible in systemic osteomyelitis), append modifier 50 and document both sides in the operative report. If performed at an ASC versus a hospital outpatient setting, reimbursement differs significantly — see the Site of Service comparison table. Modifier 22 is appropriate when operative complexity substantially exceeds the typical case (e.g., extensive debridement, prior hardware removal, or severe cortical destruction), but the operative note must quantify the additional work.

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 (7.49) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.34) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.49
Practice expense RVU	7.4
Malpractice RVU	1.45
Total RVU	16.34
Medicare national rate	$545.77
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	$545.77
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 25151 get rejected.

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

Operative note uses generic language ('bone excision performed') without specifying the technique — craterization, saucerization, or diaphysectomy — triggering medical necessity review.
Diagnosis code mismatch: billing 25151 with a fracture-only ICD-10 when the procedure is actually for osteomyelitis or tumor; payers cross-reference the indication.
Unbundling denial when 25151 is billed same-day with a closely related forearm procedure without modifier 59 or XS to establish distinct procedural service.
Modifier 22 submitted without an operative note that quantifies additional work — payers reject the upcharge when documentation doesn't explain the complexity.
Post-op E&M claims within the 90-day global period submitted without modifier 24, resulting in automatic bundling denials for visits unrelated to the index surgery.

Frequently asked questions

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

01What is the difference between CPT 25150 and 25151?

25150 is partial excision of the ulna; 25151 is partial excision of the radius. They are not interchangeable. Confirm which forearm bone was operated on before coding — payers audit this pair frequently.

02Can 25151 be billed with an E&M on the same day?

Yes, if the E&M is a significant, separately identifiable service beyond the pre-op work. Append modifier 25 to the E&M code. The same diagnosis can support both services — you don't need a different ICD-10 to justify the E&M.

03When is modifier 22 appropriate for 25151?

When operative complexity substantially exceeds the typical partial radial excision — for example, prior hardware removal, extensive osteomyelitic involvement requiring prolonged debridement, or severe cortical destruction. The operative note must explicitly describe and quantify the additional work; simply noting a longer case time is insufficient.

04Does the 90-day global period affect billing for wound care after this procedure?

Routine wound care, dressing changes, and stitch removal within 90 days are bundled into 25151 and cannot be billed separately. If a complication requires a return to the OR for a related issue, bill with modifier 78. An unrelated procedure in the global window takes modifier 79.

05Is modifier 50 ever appropriate for 25151?

Rarely, but yes — in cases of bilateral radial osteomyelitis or bilateral pathology addressed in a single operative session. Both sides must be documented separately in the operative report, and the indication for bilateral treatment must be clearly supported.

06What ICD-10 codes are most commonly paired with 25151?

Osteomyelitis of the radius (M86 series) is the most frequent indication. Benign bone tumors (D16.0), bone cysts (M85 series), and pathologic fracture through a lesion (M84.53x) are also common. The ICD-10 must match the operative pathology, not just the presenting symptom.

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 technique by name (craterization, saucerization, or diaphysectomy), the anatomic segment of radius addressed, the extent of bone removal, and the underlying pathology from dictation. This prevents the single most common audit flag for 25151 — an operative note that documents a result ('infected bone removed') without specifying the technique that maps to the code.

See how Mira captures CPT 25151 documentation