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    v1.0.28
    OpenPayerBilling CodesFracture and/or Dislocation Procedures on the Forearm and WristCPT cpt-25605-closed-reduction-distal-radius-fracture
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    CPT 25605: Closed Reduction of Displaced Distal Radius Fracture

    Medicare pays $652 and commercial payers pay $932 on average nationally for this procedure.

    CPT code 25605 describes a closed reduction of a displaced distal radial (wrist-end of the radius) fracture, where the clinician manipulates bone fragments back into alignment without making an incision; this is a closed fracture treatment procedure typically performed in an ambulatory surgical center, emergency department, or outpatient clinic and is part of orthopaedic trauma care for distal radius fractures.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    National Reimbursement Benchmarks

    Medicare’s mean rate of $652.20 sits below the BUCA average commercial mean of $931.70, indicating that commercial contracts (as represented by BUCA) pay materially more on average for CPT 25605 than the Medicare program. The gap of $279.50 highlights a notable differential between federal reimbursement levels and a commercial benchmark, with BUCA positioned well above Medicare in absolute mean dollars.

    Dispersion measured by the interquartile spread (P75 minus P25) varies across payers: Blue Cross Blue Shield has the widest IQR at $592.50 ($1,263.60 - $671.10), followed closely by UnitedHealth Group at $549.70 and Cigna at $493.60. Aetna shows the tightest IQR at $142.00, indicating relatively concentrated commercial rates around its median, while BUCA’s IQR is $556.50 and Medicare’s IQR is narrow at $70.00.

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old right-hand dominant recreational cyclist presents to the emergency department after a fall onto an outstretched hand. The patient has immediate wrist pain, swelling, and deformity. Examination and wrist radiographs confirm a displaced, closed distal radius fracture (Colles' pattern) of the right wrist, with possible concomitant ulnar styloid avulsion. The orthopedic trauma or hand surgery team evaluates the patient, documents neurovascular status, obtains informed consent, and performs closed reduction with manipulation under local or regional anesthesia in the procedure room or operating suite. Post-reduction radiographs confirm satisfactory alignment. The clinician documents technique, anesthesia type, number of manipulations, fluoroscopy use, and immobilization (splint or cast). Follow-up instructions and arrangements for repeat radiographs and orthopedic clinic visit are provided.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    25606Percutaneous skeletal fixation of distal radial fracture or epiphyseal separationUsed when closed reduction requires percutaneous pinning for fixation after manipulation; represents escalation from a closed-only procedure.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
    207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianRecognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult recons…
    207XX0801XOrthopaedic Trauma PhysicianRecognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the eval…
    207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianAn emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehic…
    2080B0002XPediatric Obesity Medicine PhysicianA physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
    207RC0001XClinical Cardiac Electrophysiology PhysicianA field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical proc…
    333600000XPharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…
    132700000XDietary ManagerA dietary manager is a trained food services professional who is charged with maintaining cost/profit objectives, purchasing foods and services for th…

    Related ICD-10-CM Codes

    19 rows

    ICD-10-CM CodeDescription
    S52.201AUnspecified fracture of shaft of right ulna, initial encounter for closed fracture
    S52.202AUnspecified fracture of shaft of left ulna, initial encounter for closed fracture
    S52.301AUnspecified fracture of shaft of right radius, initial encounter for closed fracture
    S52.302AUnspecified fracture of shaft of left radius, initial encounter for closed fracture
    S52.501AUnspecified fracture of the lower end of right radius, initial encounter for closed fracture
    S52.502AUnspecified fracture of the lower end of left radius, initial encounter for closed fracture
    S52.509AUnspecified fracture of the lower end of unspecified radius, initial encounter for closed fracture
    S52.511ADisplaced fracture of right radial styloid process, initial encounter for closed fracture
    S52.512ADisplaced fracture of left radial styloid process, initial encounter for closed fracture
    S52.521ATorus fracture of lower end of right radius, initial encounter for closed fracture

    Showing 1–10 of 19

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    Related Codes

    CPT-25500-CLOSED-TREATMENT-RADIAL-SHAFT-FRACTURE

    CPT 25500: Closed Treatment of Radius Shaft Fracture

    CPT-25505-CLOSED-TREATMENT-RADIUS-SHAFT-FRACTURE-MANIPULATION

    CPT 25505: Closed Treatment of Radial Shaft Fracture with Manipulation

    CPT-25515-OPEN-TREATMENT-RADIUS-SHAFT-FRACTURE

    CPT 25515: Open Treatment of Shaft of Radius Fracture with Fixation

    CPT-25520-CLOSED-REPAIR-RADIUS-SHAFT-DISTAL-RADIOULNAR-DISPLACEMENT

    CPT 25520: Closed Reduction of Radius Shaft Fracture with Distal Forearm Displacement

    CPT-25525-RADIUS-SHAFT-FRACTURE-WITH-DISTAL-RADIOULNAR-DISLOCATION-FIXATION

    CPT 25525: Radius Shaft Fracture Repair with Distal Radioulnar/Wrist Dislocation

    CPT-25526-RADIAL-SHAFT-FRACTURE-WITH-DISTAL-RADIOULNAR-DISLOCATION-TFCC-REPAIR

    CPT 25526: Radius Shaft Fracture Repair with TFCC Repair

    CPT-25530-CLOSED-TREATMENT-ULNA-SHAFT-FRACTURE

    CPT 25530: Closed Treatment of Ulna Shaft Fracture

    CPT-25535-CLOSED-TREATMENT-ULNA-SHAFT-FRACTURE-MANIPULATION

    CPT 25535: Closed Treatment of Ulna Shaft Fracture

    CPT-25545-OPEN-ULNA-SHAFT-FRACTURE-FIXATION

    CPT 25545: Open Reduction of Ulna Shaft Fracture

    CPT-25560-CLOSED-TREATMENT-BOTH-BONE-FOREARM-SHAFT-FRACTURE

    CPT 25560: Closed Treatment of Both-Bone Forearm Shaft Fracture

    Showing 1–10 of 36

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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