Fracture care · Wrist

25370

Multiple osteotomies of the radius or ulna with intramedullary rod realignment (Sofield-type procedure) — a single-bone forearm correctional osteotomy.

Verified May 8, 2026 · 6 sources ↓

Medicare
$940.57
Total RVUs
28.16
Global, days
90
Region
Wrist
Drawn from CMSEmednyAAPCFindacodeAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Specify which bone was treated — radius or ulna — to distinguish 25370 from 25375 (both bones)
  • Describe the number and location of osteotomy cuts made along the bone shaft
  • Document intramedullary rod type, size, and fixation method used for realignment
  • State the preoperative diagnosis and deformity characteristics (angular measurements, degree of malunion or bowing)
  • Record prior surgical history on the same bone, including implant hardware present at time of revision
  • Document the surgical approach and any neurovascular structures identified and protected

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 6 cited references ↓

CPT 25370 describes a Sofield-type correctional procedure on a single forearm bone — either the radius or the ulna — in which the shaft is divided at multiple levels to allow realignment, then stabilized with an intramedullary rod. It is the single-bone counterpart to 25375, which covers both bones in the same session. The procedure addresses severe angular deformity, malunion, or pathologic bowing that cannot be corrected with a single-cut osteotomy. Common indications include post-traumatic malunion, osteogenesis imperfecta, and fibrous dysplasia.

The 90-day global period governs all routine post-operative management through day 90. Any E/M service unrelated to the forearm realignment during that window requires modifier 24. A staged return for hardware adjustment or the contralateral bone is reported with modifier 58 if planned, or modifier 78 if an unplanned return for a related complication. Modifier 79 covers unrelated procedures performed during the global period.

Code selection between 25370 (radius OR ulna) and 25375 (radius AND ulna) is a frequent audit target. Operative notes must specify which bone was treated. If both bones are addressed in the same session, 25375 is the correct code — billing 25370 twice or appending modifier 50 is incorrect because these are not mirror-image bilateral procedures on paired limbs.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU13.75
Practice expense RVU11.48
Malpractice RVU2.93
Total RVU28.16
Medicare national rate$940.57
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$940.57
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 25370 get rejected.

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

  • Wrong code selected — 25370 billed when both radius and ulna were treated in the same session (correct code is 25375)
  • Missing or vague operative note that does not identify which bone was osteotomized or confirm use of intramedullary rod
  • Procedure billed during the global period of a prior forearm procedure without the required modifier (24, 58, 78, or 79)
  • Diagnosis code does not support the medical necessity for multiple osteotomies versus a single-cut osteotomy procedure
  • Modifier 50 appended incorrectly — 25370 is a single-bone code; bilateral forearm osteotomy on the same bone does not apply

Frequently asked questions

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

01What is the difference between CPT 25370 and CPT 25375?
25370 covers multiple osteotomies with intramedullary rod realignment on the radius OR ulna — a single bone. 25375 is used when both the radius AND ulna are treated in the same operative session. Billing 25370 twice when both bones are addressed is incorrect; use 25375 instead.
02Can modifier 50 be appended to 25370 for bilateral forearm surgery?
No. Modifier 50 applies to procedures performed on paired bilateral anatomic structures (left and right sides of the body). The radius and ulna are two distinct bones in the same forearm — not bilateral counterparts. Bilateral forearm osteotomy on the same patient in the same session is captured by 25375, not 25370 with modifier 50.
03What global period applies to 25370, and what modifiers are needed during it?
25370 carries a 90-day global period. E/M visits unrelated to the forearm procedure during that window require modifier 24. A planned staged return to the OR for the same or related bone work uses modifier 58. An unplanned return to address a complication directly related to the original procedure uses modifier 78. An unrelated surgical procedure during the global period uses modifier 79.
04What ICD-10 diagnoses typically support 25370?
Common supporting diagnoses include malunion of forearm fractures (M84.33x-), acquired deformity of forearm (M21.8x-), osteogenesis imperfecta (Q78.0), and fibrous dysplasia (M85.0x-). The diagnosis must reflect a deformity or pathology requiring multi-level osteotomy, not a single-site fracture repair.
05When should modifier 22 be used with 25370?
Append modifier 22 when the procedure required substantially more physician work than the standard case — for example, severe scarring from prior surgeries, pathologic bone requiring additional correction steps, or significantly prolonged operative time. Attach a cover letter explaining the increased complexity; payers require supporting documentation before approving the upcharge.
06Is 25370 appropriate for hardware removal combined with osteotomy in the same session?
Hardware removal (e.g., 20680) performed to allow the osteotomy may be separately reportable with modifier 59 or 51 depending on payer NCCI edits. Review the NCCI bundling table for the 25370/20680 pair before billing both — some payers bundle hardware removal as part of the revision procedure when performed through the same incision.

Mira AI Scribe

Mira's AI scribe captures the specific bone treated (radius vs. ulna), the number and anatomic level of osteotomy cuts, intramedullary rod details, and the underlying deformity diagnosis from dictation. This prevents the most common audit flag for 25370: an operative note that documents the procedure generically without confirming single-bone treatment and multi-level osteotomy — the two elements that distinguish 25370 from adjacent codes 25365 and 25375.

See how Mira captures CPT 25370 documentation

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