Summary & Overview
CPT 25525: Radial Shaft Fracture Repair with Distal Radioulnar Dislocation Reduction
CPT code 25525 denotes combined surgical management of a radial shaft fracture with a concurrent displacement of the two forearm bones at the wrist or distal radioulnar joint. The procedure typically includes an open incision to address the radial fracture with possible internal fixation and a closed reduction of the distal radioulnar dislocation that may be stabilized percutaneously. This code is clinically significant because forearm fractures with wrist involvement often require coordinated operative care and have implications for resource use, postoperative rehabilitation, and functional outcomes nationwide.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, benchmarks for typical sites of service and service types, and guidance on common billing components relevant to surgical fracture fixation and closed reductions. The publication summarizes how this code is used in practice, typical operative settings, and what to consider when mapping clinical encounters to this CPT code. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25525 describes surgical treatment for a fracture of the radial shaft with associated displacement of the forearm bones at the wrist or distal radioulnar joint. The procedure involves an incision over the fracture site to repair the radius; hardware such as plates or screws may be applied if necessary. Concurrently, the dislocation at the distal radioulnar joint is realigned without a formal open incision and may be stabilized with percutaneous pins or wires.
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Service type: Surgical fracture fixation with closed reduction of distal radioulnar dislocation (combined open and closed techniques)
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Typical site of service: Hospital operating room or ambulatory surgery center, depending on clinical complexity and patient status
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a fall onto an outstretched hand. He has deformity, localized forearm pain, swelling, and limited wrist motion. Imaging demonstrates a displaced fracture of the radial shaft with associated distal radioulnar joint (DRUJ) disruption. After initial analgesia and neurovascular check, the patient is consented for operative fixation. In the operating room under regional or general anesthesia, the orthopedic surgeon makes a surgical incision over the radial shaft fracture, performs open reduction and internal fixation (ORIF) of the radius, evaluates and reduces the DRUJ dislocation, and if necessary places percutaneous pins (K-wires) to stabilize the distal radioulnar joint. Postoperative care includes immobilization in a splint or cast, pain control, neurovascular checks, and follow-up radiographs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When procedure is performed on the left forearm/radius |
RT | Right side | When procedure is performed on the right forearm/radius |