Summary & Overview
CPT 25545: Open Treatment of Ulna Shaft Fracture
CPT code 25545 represents open surgical treatment of a fracture of the shaft of the ulna, a common procedure in orthopedic trauma care. Nationally, this code captures operative management where the surgeon exposes the forearm, reduces the fracture, and often applies internal fixation to restore alignment and stability. Accurate reporting of this code is important for tracking surgical volumes, assessing care pathways for forearm fractures, and aligning payment for operative orthopedic services.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how CPT code 25545 is used across inpatient and outpatient surgical settings and highlights clinical context relevant to coding and billing workflows.
Readers will find benchmarks for utilization and payment (where available), guidance on typical sites of service, and a clinical overview of the procedure captured by the code. The content also summarizes common modifiers and related administrative considerations. Data not available in the input will be noted explicitly where relevant.
Billing Code Overview
CPT code 25545 describes an open surgical treatment of a fracture of the shaft of the ulna. The procedure involves making an incision over the forearm, realigning the fractured ulna, and may include internal fixation such as plates, screws, or intramedullary devices to stabilize the bone.
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Service type: Open operative fracture treatment of the ulna shaft
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Typical site of service: Hospital operating room or ambulatory surgical center (inpatient or outpatient surgical setting depending on clinical severity)
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Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand-dominant male presents to the emergency department after a fall from a ladder onto his outstretched left arm. Imaging demonstrates a displaced midshaft fracture of the ulna. The orthopedic trauma surgeon evaluates the patient, discusses treatment options, and recommends open reduction and internal fixation. The patient is consented in preoperative holding. In the operating room under regional block or general anesthesia, the surgeon makes a longitudinal incision over the ulna, performs fracture reduction, and stabilizes the shaft with a plate and screws. Intraoperative fluoroscopy confirms alignment and hardware position. The patient is extubated or recovered from sedation and transferred to post-anesthesia care for monitoring. Postoperative instructions include immobilization in a splint or cast, analgesia, and arranged outpatient follow-up with radiographs to confirm healing and hardware position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no other modifier is applicable for the claim. |
26 | Professional component | Use when billing only the physician’s professional component for imaging obtained and billed separately. |