Summary & Overview
CPT 25608: Open Repair of Distal Radius Fracture with Internal Fixation
CPT code 25608 denotes open surgical repair of a distal radius fracture with internal fixation of two radial fragments using wires, screws, or pins. This operative code captures a common orthopedic procedure for displaced fractures of the larger forearm bone beyond the wrist joint. It matters nationally because distal radius fractures are frequently treated surgically, drive significant surgical and post‑acute care utilization, and are relevant to hospital and ambulatory surgery center service planning.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure and typical sites of service, as well as a national view of coverage and payment considerations by major commercial payers and Medicare. The publication provides benchmarks and comparative context, highlights relevant coding relationships, and outlines where clinical documentation commonly intersects with billing for open reduction and internal fixation of the distal radius.
This summary is intended for clinicians, coding specialists, and policy analysts seeking a concise reference for CPT code 25608, its clinical purpose, and how it factors into surgical service line planning and payer negotiations across the United States.
Billing Code Overview
CPT code 25608 describes the surgical repair of a fracture of the distal radius (the larger of the two forearm bones) beyond the wrist joint or a separation of the radius from the joint. The procedure involves an incision to access the fracture site and internal fixation of two radial bone fragments using wires, screws, or pins.
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Service type: Surgical fracture repair, open reduction with internal fixation of the distal radius
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents after a fall onto an outstretched hand with acute pain, swelling, and deformity of the distal forearm. Imaging confirms a displaced extra-articular fracture of the distal radius with two main radial fragments. Nonoperative management is attempted but closed reduction is unsuccessful or unstable. The orthopaedic surgeon schedules operative fixation under general or regional anesthesia. In the operating room the provider performs an open reduction and internal fixation of the distal radius fracture, using internal wires, screws, or pins to anatomically reduce and stabilize the two radial fragments. Typical perioperative workflow includes preoperative assessment in the ambulatory surgery center or hospital, anesthesia evaluation, intraoperative fluoroscopy for fragment alignment and hardware placement, postoperative radiographs, and routine postoperative follow-up in clinic for wound check and radiographic healing assessments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeon’s professional service separate from technical services provided by the facility or another entity. |
50 | Bilateral procedure |