Revision osteotomy of both the radius and ulna shaft with intramedullary rod fixation to correct malunion or abnormal bony development in the forearm.

Verified May 8, 2026 · 5 sources ↓

Medicare: $883.12
Total RVUs: 26.44
Global, days: 90
Region: Wrist

Drawn from CMSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify which bones were cut (radius, ulna, or both) and the level of each osteotomy
Document the type and size of intramedullary fixation used for each bone
Record the pre- and post-correction angular measurements or alignment assessment
Describe the clinical indication — malunion, deformity, or dysplastic development — with supporting imaging
Confirm that both bones were addressed in the same operative session if billing 25375
Document any bone grafting performed separately, as it may be additionally reportable

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 59 Distinct service 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 5 cited references ↓

CPT 25375 describes a corrective osteotomy of both forearm bones — the radius and ulna — performed together in a single operative session. The surgeon cuts each shaft at one or more levels and repositions the bone segments to restore alignment, stabilizing the correction with intramedullary rods. This is not a fracture repair; it is a deliberate revision procedure targeting malunion, angular deformity, or dysplastic bone development that has resulted in functional impairment.

The 90-day global period covers the surgery, the day-before visit, and all routine post-op care through day 90. Any unrelated E/M or procedure billed within that window requires modifier 24 or 79, respectively. Revision procedures returning to the OR for a complication related to the original surgery use modifier 78.

Site of service matters here. The HOPD and ASC payments differ significantly — see the Site of Service comparison table. Because this procedure involves two bones and intramedullary instrumentation, operative note specificity is non-negotiable: auditors look for documentation of each osteotomy site, the fixation method for each bone, and the measured correction achieved.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	13.21
Practice expense RVU	10.41
Malpractice RVU	2.82
Total RVU	26.44
Medicare national rate	$883.12
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	$883.12
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 25375 get rejected.

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

Operative note lacks individual documentation for each bone's osteotomy, making bilateral work unverifiable
ICD-10 diagnosis code does not support revision or corrective intent — original fracture codes misused
Procedure billed during another surgeon's global period without modifier 79 or appropriate documentation of unrelatedness
Missing or vague description of fixation method flagged during pre-payment review
Unbundling attempt: separately reporting intramedullary rod insertion already included in 25375

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can I bill 25375 if only one of the two forearm bones required osteotomy?

No. 25375 requires osteotomy of both the radius and ulna. If only one bone is addressed, report the single-bone osteotomy code instead — 25350 for radius or 25355 for ulna.

02Is bone grafting included in 25375 or separately reportable?

Autogenous bone grafting performed at the osteotomy site may be separately reportable depending on the source and technique. NCCI policy requires that graft harvesting and application be documented distinctly from the osteotomy work to support a separate code.

03What modifier applies if the patient returns to the OR within the 90-day global for a complication directly related to 25375?

Use modifier 78. That signals an unplanned return to the OR for a complication related to the original procedure. Do not use modifier 79 — that is for unrelated procedures only.

04Does the 90-day global period affect same-day E/M billing?

If you perform a significant and separately identifiable E/M on the same day as 25375 — for example, evaluating an unrelated condition — append modifier 25 to the E/M. The visit must be documented as distinct from the pre-op assessment for the procedure itself.

05Can 25375 be billed with modifier 22 for increased complexity?

Yes, if the procedure required substantially more work than typical — severe deformity, prior hardware removal, or extensive scarring from prior surgery. Documentation must explicitly describe why the complexity exceeded normal, and the increase should be quantified in the operative note. Without that narrative, payers routinely deny modifier 22 uplifts.

06Is 25375 performed in an ASC or HOPD setting typically, and does it matter for payment?

Both settings are used. Payment rates differ — see the Site of Service comparison on this page. The clinical and patient-specific factors drive setting selection, but the payment differential is substantial and worth factoring into scheduling decisions when appropriate.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the osteotomy level for each bone, the fixation construct (rod type, size, insertion technique), pre-correction and post-correction alignment, and the clinical rationale for revision from dictation. This prevents the most common audit flag on 25375: operative notes that confirm a procedure was done but fail to document the work performed on each individual bone, which reviewers treat as insufficient support for the bilateral scope of the code.

See how Mira captures CPT 25375 documentation