Secondary closure or scar revision following forearm amputation through the radius and ulna, performed to remodel soft tissue after inadequate initial closure or painful contracture.

Verified May 8, 2026 · 6 sources ↓

Medicare: $585.52
Work RVU: 7.89
Global, days: 90
Region: Wrist

Drawn from CMSAAPCAxogenincEatonhandNIH

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the indication — inadequate primary closure versus painful scar contracture versus prosthetic fitting failure — and document which finding drove the decision to reoperate.
Describe the tissue layers addressed: skin, subcutaneous tissue, fascia, and muscle, including which structures were excised, revised, or remodeled.
Note the laterality (left, right, or bilateral) in both the operative note header and the body of the report.
Record the relationship to the original amputation: date of primary procedure, surgeon of record, and whether this revision falls within or outside the prior global period.
If modifier 22 is appended, include a written justification quantifying the additional work — unusual scarring, infection, prior failed revision, or anatomic complexity.
Document final stump configuration, closure technique, and prosthetic-readiness assessment or referral plan.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 25907 covers surgery performed after a forearm amputation (through both the radius and ulna) when the original closure was inadequate or when scar contracture has caused pain or functional compromise. The surgeon remodels skin and muscle at the residual limb — revising scar tissue, releasing contracture, or refashioning soft-tissue coverage — to produce a stable, functional stump. This is a distinctly different encounter from the primary amputation; it is not routine post-op wound care, which would fall within the global period of the original procedure.

With a 90-day global period attached to 25907 itself, any subsequent office visits related to healing of the revision are bundled. If the patient requires a further unplanned return to the OR for a related complication within that global window, bill with modifier 78. A staged, planned return for additional revision by the same surgeon uses modifier 58. Unrelated procedures during the global period use modifier 79.

Bilaterally amputated forearms revised in the same session require modifier 50. If 25907 is performed alongside other distinct procedures on the same date, modifier 51 applies to the lower-value code. Always confirm whether modifier 59 or XS is needed to unbundle from any concurrently billed soft-tissue or nerve procedure — payer NCCI edits for amputation revision codes warrant pre-submission review.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (7.89) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.53) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.89
Practice expense RVU	7.96
Malpractice RVU	1.68
Total RVU	17.53
Medicare national rate	$585.52
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	$585.52
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 25907 get rejected.

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

Bundling into the global period of the original amputation code — payers deny 25907 when it falls within the 90-day global of 25900 or 25905 without modifier 58 or 79.
Missing or ambiguous laterality — claims without LT or RT modifier are rejected by most payers for upper-extremity codes.
Insufficient documentation of medical necessity — operative notes that only say 'scar revision' without describing the functional impairment or failed healing trigger medical-necessity denials.
Incorrect modifier use — appending modifier 78 for a planned staged revision instead of modifier 58, or vice versa, causes payment delays and take-backs.
Procedure billed as a new surgery rather than a revision when the original amputation is still in its global period and no modifier is present.

Frequently asked questions

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

01Does 25907 have its own 90-day global period, or does it extend the original amputation's global?

25907 carries its own 90-day global period that starts on the date of the revision surgery. It does not extend the global of the original amputation. Post-op visits related to the revision are bundled into 25907's global window.

02Which modifier do I use when 25907 is performed during the global period of the primary amputation by the same surgeon?

Use modifier 58 if the revision was staged or planned, or if it is more extensive than originally anticipated. Use modifier 78 only for an unplanned return to the OR for a related complication. Never use 79 for a related procedure — that modifier is for unrelated procedures in the global window.

03Can I bill 25907 with a neuroma excision code if the surgeon also removes a painful neuroma at the stump?

Potentially yes, but check NCCI edits for the specific neuroma code pairing. If the edit allows unbundling, use modifier 59 or XS to indicate a distinct structure or service. Document each procedure separately in the operative note.

04Is modifier 50 appropriate if both forearm stumps are revised in the same session?

Yes. Bill 25907 once with modifier 50 to indicate bilateral performance. Most payers reimburse bilateral procedures at 150% of the single-procedure rate, billed on one line.

05What ICD-10 diagnosis codes support medical necessity for 25907?

Common supporting diagnoses include acquired absence of forearm (Z89.2x), painful or complicated amputation stump (T87.3x, T87.4x), or contracture of amputation stump (T87.89). Match the code to the documented indication — inadequate closure, contracture, or prosthetic-fitting barrier — to avoid medical-necessity denial.

06Is 25907 payable in an ASC setting under Medicare?

Yes. CMS assigns 25907 an ASC-payable status indicator. See the Site of Service comparison table on this page for the current 2026 facility payment rates.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the specific indication for revision (failed closure, contracture, prosthetic-fitting barrier), the tissue layers addressed, laterality, and the date and CPT of the original amputation — the details auditors check first. That documentation locks in the modifier logic (58 vs. 78 vs. 79) before the claim is built, preventing the most common denial reason for 25907: bundling into the prior global period without a valid modifier.

See how Mira captures CPT 25907 documentation