2025 CPT code 25415
(Active) Effective Date: N/A Revision Date: N/A Surgery - Fracture and Dislocation Treatment Musculoskeletal System Feed
Repair of nonunion or malunion in both the radius and ulna bones, without the use of a bone graft.
Modifiers such as LT (left side), RT (right side), 51 (multiple procedures), and 76 (repeat procedure) may be applicable depending on the circumstances of the procedure.
Medical necessity is established by the presence of a documented nonunion or malunion of the radius and ulna that is causing significant pain, functional limitation, or deformity.Conservative treatment options should have been attempted and failed before surgical intervention is considered medically necessary.
The orthopedic surgeon is responsible for performing the surgical repair, including incision, bone excision, realignment, fixation, irrigation, suturing, and splint application. Pre-operative and post-operative care may be provided by other medical professionals.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Fracture and Dislocation Treatment
In simple words: This surgery fixes a broken radius and ulna bone in the forearm that hasn't healed correctly. The doctor will realign the bones and use things like screws and plates to hold them in place while they heal, without needing to add extra bone.
This surgical procedure involves the repair of a nonunion or malunion of both the radius and ulna bones in the forearm.The procedure corrects improper healing of fractures in these bones without using a bone graft.Techniques such as compression are used to realign and stabilize the fractured bones, promoting proper healing.The procedure includes excision of the irregular bony areas, realignment of the bone ends, and fixation using methods such as screws and plates.The surgical site is irrigated, sutured, and a splint is applied for immobilization.
Example 1: A patient presents with a nonunion of the radius and ulna following a motorcycle accident six months prior.The orthopedic surgeon performs an open reduction and internal fixation (ORIF) using plates and screws to stabilize the fracture., A patient sustains a comminuted fracture of both the radius and ulna in a fall. After failed conservative management, the patient undergoes surgery to correct a malunion.Compression plating is used to stabilize the bones. , A patient has a history of osteoporosis and suffered a low-energy fracture of both bones in the forearm.After a period of cast immobilization, a nonunion is identified.The surgeon performs an ORIF with internal fixation.
* Preoperative diagnosis and imaging studies (X-rays, CT scans) demonstrating the nonunion or malunion.* Operative report detailing the surgical technique, including the type of fixation used.* Postoperative imaging studies confirming the reduction and fixation.* Appropriate progress notes documenting the patient's recovery.
** Always consult the most up-to-date CPT codebook and payer-specific guidelines for accurate coding and reimbursement.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The relative value units (RVUs) for this code will vary depending on the location and specific circumstances of the procedure.Consult the most current Medicare Physician Fee Schedule for RVU values.
- Global Days: The global period for this procedure will depend on several factors and should be confirmed using the most current local payer guidelines and fee schedules.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier may apply if appropriate depending on the circumstances. The exact criteria would be determined locally by payer and individual circumstances.
- Fee Schedule: Fee schedules vary significantly by location, payer, and other factors.Refer to historical fee schedule databases for pricing information.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital