Closed treatment of a distal radius fracture or epiphyseal separation, including the ulnar styloid if fractured, performed without manipulation of the bone fragments.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $385.45
- Total RVUs
- 11.54
- Global, days
- 90
- Region
- Wrist
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Explicit statement that no manipulation was performed — vague language invites downcoding to a non-procedure E/M
- Fracture type and pattern (e.g., Colles, Smith, epiphyseal separation) supported by imaging report
- Displacement status and description of the fracture fragment position at presentation
- Laterality — left, right, or bilateral — documented in the note and matched on the claim
- Ulnar styloid involvement noted if present, confirming no separate code is warranted
- Immobilization type applied (cast, splint, brace) and material used, if any
- Clinical rationale for non-operative management without reduction
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 5 cited references ↓
CPT 25600 covers closed treatment of a distal radius fracture — including classic patterns such as Colles and Smith type — or an epiphyseal separation at the distal radius, without any manipulation. If an ulnar styloid fracture is also present, its closed treatment is included in this code and not separately billable. No incision is made, and the provider does not reduce or reposition the fracture fragments. The code applies whether or not the fracture involves the distal radial epiphysis (growth plate).
The 90-day global period means that casting, splinting, and all routine follow-up visits related to the fracture care are bundled through day 90. Any E/M service billed on the same day as 25600 requires modifier 57 (decision for surgery), not modifier 25 — because the global period exceeds 90 days. Unrelated E/M visits during the global window require modifier 24. If the fracture ultimately requires manipulation, upgrade to 25605; if percutaneous fixation is added, 25606 applies instead.
This code is billed predominantly by orthopedic surgery, hand surgery, and sports medicine. Document the fracture type, the absence of manipulation, displacement status, and the treating extremity. Payers routinely scrutinize whether manipulation actually occurred; operative or encounter notes that are vague about technique can trigger downcoding to 25600 or denial of 25605.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 2.71 |
| Practice expense RVU | 8.28 |
| Malpractice RVU | 0.55 |
| Total RVU | 11.54 |
| Medicare national rate | $385.45 |
| 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 | $385.45 |
HOPD (APC 5111) Hospital outpatient department | $252.01 |
ASC (PI P2) Ambulatory surgical center (freestanding) | $135.54 |
Common denial reasons
The recurring reasons claims for CPT 25600 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Upcoding concern: payer downcodes to an E/M when documentation doesn't clearly distinguish treatment from evaluation alone
- Modifier 25 appended to a same-day E/M instead of required modifier 57, triggering rejection under 90-day global rules
- Bilateral billing without modifier 50 or separate line items when both wrists are treated
- Missing laterality modifier (LT/RT) required by payer, causing claim suspension or denial
- Unbundling: ulnar styloid fracture billed separately when it should be included in 25600
- Diagnosis code mismatch — ICD-10 code specifying displaced fracture paired with 25600 (no manipulation), prompting medical review
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01What is the difference between 25600 and 25605?
02Which modifier goes on the E/M when 25600 is billed the same day?
03Is the ulnar styloid fracture billed separately alongside 25600?
04Can 25600 be billed bilaterally?
05What ICD-10 codes pair with 25600, and does displacement matter for code selection?
06If the fracture later requires surgery within the 90-day global, how is that billed?
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 fracture pattern and type (Colles, Smith, epiphyseal), explicit confirmation that no manipulation was performed, displacement status, immobilization applied, ulnar styloid involvement, and laterality — all from the provider's dictation. That documentation set directly prevents the most common audit flag for 25600: a note so light on technique detail that reviewers can't distinguish closed treatment from a routine evaluation visit.
See how Mira captures CPT 25600 documentation