Open treatment of a radial shaft fracture with internal fixation, combined with closed reduction of a distal radioulnar joint dislocation (Galeazzi fracture-dislocation), including percutaneous skeletal fixation of the DRUJ when performed.

Verified May 8, 2026 · 6 sources ↓

Medicare: $736.82
Total RVUs: 22.06
Global, days: 90
Region: Wrist

Drawn from CMSFastrvuAAPCBillrazorAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Confirm radial shaft fracture was treated with open technique and internal fixation
Explicitly document that the DRUJ dislocation was reduced by closed means — include whether percutaneous skeletal fixation of the DRUJ was performed
Specify that open DRUJ treatment and TFCC repair were NOT performed (distinguishes 25525 from 25526)
Record laterality (left or right) in both the operative note and on the claim
Document pre-operative imaging confirming Galeazzi fracture-dislocation pattern
If a decision for surgery E/M was billed same-day, confirm modifier 57 is appended and that the note supports the medical decision-making level billed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 25525 covers the Galeazzi fracture-dislocation treated with open fixation of the radial shaft and closed reduction of the distal radioulnar joint (DRUJ). The radial shaft component requires open surgery with internal fixation; the DRUJ component is handled by closed means — with or without percutaneous skeletal fixation. If the DRUJ requires open treatment and TFCC repair, that's 25526, not 25525. The distinction between these two codes turns entirely on how the DRUJ was managed, so the operative note must document the DRUJ reduction technique explicitly.

This is a 90-day global code. Any E/M on the day of or day before surgery needs modifier 57 (decision for major surgery). Routine post-op visits, dressing changes, and cast checks through day 90 are bundled. Unrelated problems billed in the global window need modifier 24. Laterality modifiers LT or RT are required — apply them to the fracture care code.

If additional procedures such as open wound debridement are performed and are not bundled into 25525 per NCCI, append modifier 51 to the secondary code. Confirm NCCI edits before billing 25515 (radial shaft open treatment alone) alongside 25525 — the DRUJ closure component in 25525 already incorporates the radial shaft fixation, making 25515 redundant and potentially triggering a bundling denial.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	10.29
Practice expense RVU	9.71
Malpractice RVU	2.06
Total RVU	22.06
Medicare national rate	$736.82
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	$736.82
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,941.39

Common denial reasons

The recurring reasons claims for CPT 25525 get rejected.

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

DRUJ reduction technique not documented — payer cannot confirm closed vs. open management, triggering downcoding or denial
Billing 25515 alongside 25525 — radial shaft fixation is already included in 25525, creating an NCCI bundling conflict
Missing laterality modifier LT or RT on the claim
Presurgical E/M billed with modifier 25 instead of modifier 57 — this is a 90-day global code requiring modifier 57 for the decision-for-surgery visit
Operative note states 'standard approach' or 'DRUJ reduced' without specifying technique, flagging the record during audit

Frequently asked questions

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

01What separates 25525 from 25526?

In 25525, the DRUJ is handled by closed reduction with or without percutaneous pins. In 25526, the DRUJ is opened surgically and the TFCC is repaired. If the DRUJ was opened and the TFCC repaired, 25526 is the correct code — 25525 is a downcoded mismatch.

02Can I bill 25515 and 25525 together?

No. CPT 25525 already includes open treatment and internal fixation of the radial shaft. Billing 25515 alongside it duplicates that component and will trigger an NCCI bundling denial.

03Which modifier goes on the pre-op E/M for a 25525 case?

Modifier 57. All radial/ulnar fracture care codes in this family carry a 90-day global period. The decision-for-surgery E/M requires modifier 57, not modifier 25. Modifier 25 applies to minor (0- or 10-day global) procedures.

04Is laterality required on the claim?

Yes. Append LT or RT to 25525. Omitting laterality is a common clean-claim failure and can trigger an automated denial or a request for additional documentation.

05If the DRUJ wasn't documented as reduced, should I still bill 25525?

No. If the operative note doesn't confirm DRUJ reduction, 25525 is unsupportable. Query the surgeon before billing. If the DRUJ was not addressed, 25515 (open radial shaft treatment only) is the appropriate code.

06Can modifier 22 be used with 25525 for unusual complexity?

Yes, if the procedure was substantially more complex than typical — for example, revision after failed prior fixation, severe comminution, or significantly increased operative time. Document the added complexity in the operative note and attach a cover letter explaining the basis for the increased-service modifier.

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 radial shaft fixation technique (approach, implant type), the DRUJ reduction method (closed vs. percutaneous vs. open), whether TFCC repair was performed, and laterality — all from dictation. That prevents the most common 25525 denial: an operative note that confirms radial fixation but is silent on how the DRUJ was managed, which auditors and payers treat as insufficient documentation for the combined code.

See how Mira captures CPT 25525 documentation