Summary & Overview
CPT 25520: Closed Repair of Radial Shaft Fracture with Distal Radioulnar Displacement
CPT code 25520 represents a closed procedure to repair a fracture of the radial shaft combined with displacement involving the distal radioulnar joint or the two forearm bones at the wrist. It denotes a nonincisional, closed reduction and stabilization technique used in acute orthopedic trauma care. Nationally, this code captures a common set of urgent and elective fracture-management encounters that affect surgical coding, resource use, and post-acute care pathways.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the code, typical sites of service, common procedural context, and the types of documentation that generally support billing for closed fracture repair at the distal forearm. The publication also summarizes benchmark considerations and payer-related coverage context where available, and flags where input data is not present.
This summary is intended for a national audience of clinicians, coding professionals, and policy analysts seeking concise guidance on the clinical meaning and billing context of CPT code 25520, including where the procedure is typically performed and why correct code selection matters for claims processing and care coordination.
Billing Code Overview
CPT code 25520 describes a closed repair of a fracture of the shaft of the radius with displacement of the two bones in the forearm at the wrist or distal radioulnar joint. The procedure is performed without making an incision, indicating a closed-manipulation technique to realign and stabilize the fracture.
Service type: Closed fracture management / orthopedic closed repair
Typical site of service: Hospital inpatient or outpatient surgical setting, ambulatory surgical center, or emergency department where closed reduction and fixation procedures are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who sustained an acute closed distal forearm injury after a fall onto an outstretched hand. The patient presents to the emergency department with pain, swelling, and deformity of the wrist and forearm. Imaging (radiographs) demonstrates a closed transverse or oblique fracture of the radial shaft with associated displacement at the distal radioulnar joint or an associated distal radius/ulna fragment without an open wound. The orthopedic or hand surgeon performs a closed reduction of the radial shaft fracture and manipulative realignment of the distal radioulnar relationship without making a surgical incision. The procedure is usually done in the operating room or procedure suite under regional block or general anesthesia, with intraoperative fluoroscopy used to confirm reduction. Post-procedure immobilization with a cast or splint is applied and the patient receives follow-up radiographs and clinic visits for monitoring healing and possible conversion to internal fixation if reduction is unstable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No specific modifier (default) | Use when no qualifier modifier applies to the service |
22 | Increased procedural services |