{
    "code": "25609",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/25609/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/25609/2018/D",
    "description": "Surgical repair of a broken wrist at the far end of the radius, where the fracture runs into the joint surface and has shattered into three or more pieces. The bone is exposed, the fragments are lifted back into alignment, and plates, screws, or pins hold them there. It sits at the top of a graded family: simpler breaks that stay outside the joint, or that split the joint into just two pieces, are reported with neighboring codes.",
    "answer": {
        "question": "How much did Medicare pay for CPT 25609 in Q4 2018?",
        "text": "Medicare paid $1,085.03 for CPT 25609 in the office (non-facility) setting and $1,085.03 in a facility under the Q4 2018 Physician Fee Schedule, effective October 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it increased 0.5%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "D",
        "label": "Q4 2018",
        "effective": "October 1 – December 31, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 1085.03,
        "facility": 1085.03,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 14.38,
        "practice_expense_non_facility": 13.08,
        "practice_expense_facility": 13.08,
        "malpractice": 2.68
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q4 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/D",
        "file": "PPRRVU18_OCT.csv",
        "row": 6469,
        "sha256": "c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d"
    },
    "modified_at": "2026-08-04T03:08:37+00:00"
}