Summary & Overview
CPT 25500: Closed Treatment of Radius Shaft Fracture
CPT code 25500 denotes closed treatment of a fracture of the shaft of the radius where no incision is made and no fracture manipulation is performed. This code captures a specific nonoperative, immobilization-focused encounter for a common forearm injury and is relevant across acute care, emergency, and outpatient orthopedic settings. Nationally, accurate use of 25500 affects clinical documentation, billing compliance, and appropriate payment for noninvasive fracture care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for radial shaft fractures, typical sites of service where 25500 is billed, and common coding considerations tied to nonoperative management. The publication summarizes available benchmarks and policy-relevant points related to claims submission and utilization patterns where data are available. Where input fields are incomplete, the text notes that specific items are not provided in the source.
This resource is intended for billing staff, practice managers, and clinical coders seeking a concise reference on the clinical meaning and billing context of CPT code 25500, including expected care settings and the scope of services represented by the code.
Billing Code Overview
CPT code 25500 describes treatment of a fracture of the shaft of the radius in a closed procedure. The provider treats the forearm fracture without making a surgical incision and without performing manipulation of the fracture.
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Service type: Closed treatment of radial shaft fracture (nonoperative, no manipulation)
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Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be provided in an emergency department or outpatient orthopedic clinic depending on clinical setting and patient needs.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents to the emergency department or orthopedic urgent care after a fall onto an outstretched hand with forearm pain, swelling, and possible deformity. Initial evaluation includes history, focused physical exam, and forearm radiographs confirming an isolated closed fracture of the radial shaft. The provider performs a closed treatment without incision or manipulation under local or regional anesthesia or conscious sedation — for example, immobilization in a long arm cast or splint applied in the ED or procedure area. Post-procedure workflow includes post-reduction (if applicable) radiographs, neurovascular reassessment, documentation of immobilization technique and patient instructions, and scheduling orthopedic follow-up for repeat imaging and potential operative management if displacement or healing complications arise. Typical site of service is the emergency department, ambulatory surgery center, or office-based procedure room depending on acuity and need for sedation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for a closed radial shaft treatment (rare for 25500). |