Closed treatment of a distal radioulnar joint (DRUJ) dislocation using manual manipulation to restore joint alignment without surgical incision.

Verified May 8, 2026 · 5 sources ↓

Medicare: $579.84
Total RVUs: 17.36
Global, days: 90
Region: Wrist

Drawn from CMSEmednyAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Identify the specific joint as the distal radioulnar joint — not radiocarpal or intercarpal
Document direction of dislocation (dorsal or volar displacement of the ulnar head)
Describe the reduction maneuver performed and the number of attempts
Record post-reduction stability assessment and neurovascular status
Note post-reduction imaging findings confirming joint realignment
Document immobilization type and position applied after reduction

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 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 25675 covers closed reduction of a distal radioulnar joint dislocation — meaning the treating provider manually restores the articulation between the distal radius and ulna without opening the wrist. This is a distinct procedure from radiocarpal or intercarpal dislocation treatment (25660) and from the open (25676) or percutaneous fixation (25671) approaches. The 90-day global period means all routine follow-up, immobilization checks, and cast management through day 90 are bundled. A separate E/M during that window requires modifier 24 if unrelated, or modifier 25 if a significant, separately identifiable service on the same day as the procedure.

The DRUJ is mechanically distinct from the radiocarpal joint — auditors will flag operative or clinical notes that conflate the two. Document the specific joint involved, the direction of dislocation (dorsal vs. volar ulnar head displacement), the reduction maneuver performed, and post-reduction stability assessment. Post-reduction imaging to confirm alignment is expected and supports medical necessity. If the dislocation is associated with a distal radius fracture, carefully evaluate whether 25675 is appropriate standalone or whether a fracture code better captures the dominant procedure.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	4.77
Practice expense RVU	11.46
Malpractice RVU	1.13
Total RVU	17.36
Medicare national rate	$579.84
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	$579.84
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 25675 get rejected.

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

Joint not clearly specified as DRUJ — notes say 'wrist dislocation' without anatomical precision
Bundling conflict when billed same-day with a distal radius fracture code without appropriate modifier
Lack of post-reduction imaging documentation undermining medical necessity support
Global period violation — follow-up E/M billed without modifier 24 during the 90-day window
Upcoding flag when 25675 is billed but documentation describes only immobilization without a documented reduction maneuver

Frequently asked questions

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

01What distinguishes 25675 from 25660?

25660 covers closed treatment of a radiocarpal or intercarpal dislocation. 25675 is specific to the distal radioulnar joint. The anatomical distinction must be explicit in the note — 'wrist dislocation' alone won't support either code at audit.

02Can 25675 be billed with a distal radius fracture code on the same date?

Only if the DRUJ dislocation is a distinct injury treated as a separate procedure. Document each injury and each reduction independently. Modifier 59 or XS may be required to bypass NCCI bundling edits depending on the fracture code billed alongside.

03What does the 90-day global cover for 25675?

All routine post-reduction visits, cast and splint changes, and follow-up imaging interpretation through day 90 are bundled. Unrelated E/M services need modifier 24. A new significant problem evaluated the same day as the procedure needs modifier 25.

04When is modifier 22 appropriate for 25675?

Use modifier 22 when the reduction required substantially greater work than typical — for example, a chronically locked DRUJ, obesity complicating manipulation, or multiple failed reduction attempts under sedation. The operative or procedural note must spell out what made it unusually difficult.

05Is conscious sedation billable separately when performing closed reduction under 25675?

Moderate sedation is not bundled into 25675 by CPT convention for this code range. If moderate sedation is provided by the same physician, report 99151–99153 as appropriate. Confirm payer policy — some commercial plans bundle it anyway.

06If the DRUJ re-dislocates during the global period, what modifier applies?

If the same surgeon performs a repeat closed reduction of the same DRUJ, use modifier 76 (repeat procedure by same physician). If a different surgeon performs it, use modifier 77. If the provider escalates to open treatment or percutaneous fixation during the global, use modifier 78 for a return related to the original procedure.

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 specific joint (DRUJ), dislocation direction, reduction technique, number of attempts, post-reduction stability exam, and immobilization details from the provider's dictation. This prevents the most common audit flag for 25675 — notes that document a wrist dislocation without distinguishing the distal radioulnar articulation from the radiocarpal joint.

See how Mira captures CPT 25675 documentation