Summary & Overview
CPT 25405: Corrective Osteotomy of Radius or Ulna with Autograft
CPT code 25405 represents an open corrective osteotomy of the radius or ulna for nonunion or malunion with autogenous bone grafting. This procedure addresses failed bone healing or deformity in the lower arm by resecting the abnormal bone and stabilizing the segment with internal fixation and a graft taken from the patient's own body. Nationally, procedures addressing upper-extremity nonunions carry implications for surgical resource use, post-operative rehabilitation, and durable medical equipment and can affect patient functional outcomes and return-to-work timelines.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary provides the clinical context, typical sites of service, and payer coverage framing. Readers will find benchmarks and utilization patterns where available, coding and billing guidance around service descriptors, and clinical context that highlights indications and expected service settings. The content also summarizes common modifiers and administrative considerations when billing CPT code 25405. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25405 describes an open osteotomy with autograft for nonunion or malunion of the radius or ulna. The procedure involves surgically cutting the malformed or nonunion segment of the bone and using a bone graft harvested from the patient's own body to promote healing and restore alignment.
Service type: Orthopedic surgical procedure — corrective osteotomy with autogenous bone grafting
Typical site of service: Hospital operating room or ambulatory surgical center, performed by orthopedic or hand surgeons
Clinical & Coding Specifications
Clinical Context
A 32-year-old right-hand dominant male presents with persistent pain, deformity, and improper healing of a distal radius fracture sustained 9 months earlier. Imaging demonstrates a symptomatic nonunion with malalignment of the radius causing decreased wrist range of motion and impaired forearm rotation. After nonoperative measures failed, the orthopedic surgeon schedules operative correction.
Preoperative workflow includes history and physical, informed consent discussing open osteotomy and autogenous bone grafting, pre-op labs, and imaging (plain radiographs ± CT). In the operating room under regional block or general anesthesia, the orthopedic surgeon performs exposure of the radius, resects fibrous nonunion tissue, performs corrective osteotomy, harvests autogenous cancellous bone graft (commonly from the iliac crest), and secures the osteotomy with internal fixation (plates and screws). Intraoperative fluoroscopy documents alignment. Postoperative workflow includes pain control, immobilization in a splint or cast, discharge planning with activity restrictions, and scheduled follow-up with serial radiographs to assess union and hardware position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the work required is substantially greater than usually required (document reasons and additional resources). |