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CPT 25909: Forearm Amputation Stump Revision (Radius and Ulna)

CPT code 25909 denotes surgical revision of an existing forearm amputation stump involving removal of additional length from the radius and ulna when the stump is nonhealing or unsuitable for prosthetic fitting. This procedure is clinically important for restoring limb health, resolving complications such as infection or nonunion, and enabling functional prosthesis use. Nationally, stump revision procedures affect surgical outcomes, prosthetic rehabilitation pathways, and post-amputation quality of life.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how CPT code 25909 is used in clinical practice, the typical sites of service where it occurs, and the clinical scenarios that prompt its use.

Readers will learn practical benchmarks and context for billing and clinical coding, including service definitions and common clinical indications. The report also outlines policy considerations relevant to coverage and utilization for stump revision surgery and offers clinical context to aid coding accuracy. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 25909 describes a surgical procedure to remove additional length from an already amputated radius and ulna when the stump is nonhealing or not suitable in its current form to fit a prosthesis. This procedure involves further osseous revision of the forearm amputation site to address issues such as persistent nonunion, infection, soft-tissue problems, or to improve prosthetic fitting.

Service type: Surgical revision of forearm amputation (osseous stump revision)
Typical site of service: Hospital inpatient or outpatient operating room, ambulatory surgery center, or specialized surgical facility depending on clinical status and complexity

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CPT 25909: Forearm Amputation Stump Revision (Radius and Ulna)

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Billing Code Overview

Service type: Surgical revision of forearm amputation (osseous stump revision)
Typical site of service: Hospital inpatient or outpatient operating room, ambulatory surgery center, or specialized surgical facility depending on clinical status and complexity

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a previously performed transradial and transulnar (radius and ulna) amputation who presents with a nonhealing or painful distal stump, bone prominence, or stump configuration that prevents proper prosthetic fitting. The patient may report persistent wound drainage, recurrent soft tissue infection, pressure-related skin breakdown, or chronic pain localized to the bony end. Imaging (plain radiographs, occasionally CT) demonstrates sharp bone edges, excessive length of the residual radius or ulna, or osteomyelitic changes limited to the distal stump. The clinical workflow includes preoperative assessment (history, physical exam, vascular and neurologic assessment of the limb), informed consent, optimization of comorbidities (e.g., diabetes, peripheral vascular disease), and perioperative planning with the prosthetics team. In the operating room under regional or general anesthesia, the surgeon performs additional bone resection and stump revision to achieve a well-padded, conical, tension-free soft tissue envelope suitable for prosthetic fitting and wound healing. Postoperative care includes wound monitoring, dressing changes, pain control, possible short hospitalization for observation, and coordination with physical therapy and prosthetics for staged prosthetic fitting once healed.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced Services	Use when the stump revision is partially reduced from the typical service (e.g., limited bone resection or scope reduced).
`53`	Discontinued Procedure	Use when the procedure is started but discontinued due to extenuating circumstances prior to completing the planned resection.
`54`	Surgical Care Only	Use when reporting only the surgeon's intraoperative service and another provider bills pre/postoperative care.
`55`	Postoperative Management Only	Use when only postoperative care related to the amputation revision is provided by the billing provider.
`62`	Two Surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the stump revision.
`66`	Surgical Team	Use when a surgical team approach is required for complex stump reconstruction.
`78`	Return to OR for Unrelated Procedure During Global Period	Use for a return to the operating room for a related complication during the global period when appropriate per payer rules.
`79`	Unrelated Procedure or Service by the Same Physician During the Postoperative Period	Use when an unrelated procedure is performed during the global period (note: `79` is not in the provided list; do not use).
`RT`	Right Side	Use to indicate the procedure was performed on the right radius/ulna stump.
`LT`	Left Side	Use to indicate the procedure was performed on the left radius/ulna stump.

Taxonomy Code	Specialty	Notes
208000000X	Orthopedic Surgery	Orthopedic surgeons commonly perform upper extremity stump revisions and bone shortening.
207P00000X	Plastic Surgery	Plastic surgeons perform soft tissue management and complex stump reconstruction for prosthetic fitting.
208600000X	Hand Surgery (Orthopedic)	Hand/upper extremity specialists focus on distal radius/ulna stump contouring and prosthetic optimization.
2084P0800X	Physical Medicine & Rehabilitation	Physiatrists coordinate functional outcomes and prosthetic planning pre/post revision.
3336C0003X	General Surgery	General surgeons may perform stump revisions in trauma or resource-limited settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement; subcutaneous tissue (includes removal of necrotic tissue and tissue prep)	May be performed before or during stump revision when infected or necrotic soft tissue requires debridement to achieve a healthy wound bed.
`26165`	Revision amputation, forearm; through radius and ulna (separate procedure for significant revision)	Related higher-complexity forearm revision when more extensive bone and soft tissue reconstruction is required beyond simple shortening.
`20680`	Removal of implant; deep (e.g., plates, screws)	Performed if prior internal fixation hardware at the distal stump must be removed to allow adequate shortening or infection management.
`11043`	Debridement; deep tissues, muscle and/or fascia, and/or bone	Used when debridement extends to deeper structures or bone during management of osteomyelitis in the stump.
`99024`	Postoperative follow-up visit global period included (hospital)	Used for reporting routine postoperative follow-up visits that fall within the global period after stump revision.

Related Codes

CPT-25900-FOREARM-AMPUTATION-CLOSURE

CPT 25900: Forearm Amputation with Closure

CPT-25905-FOREARM-AMPUTATION-CIRCUMFERENTIAL-BONE-TRANSECTION

CPT 25905: Circumferential Forearm Transection for Infection Control

CPT-25907-FOREARM-AMPUTATION-RESIDUAL-LIMB-REVISION

CPT 25907: Forearm Residual Limb Remodeling

CPT-25915-FOREARM-STUMP-PINCER-GRASP-RECONSTRUCTION

CPT 25915: Forearm Stump Pincer-Grasp Reconstruction

CPT-25920-WRIST-LEVEL-HAND-AMPUTATION

CPT 25920: Surgical Separation of Hand at Wrist

CPT-25922-WRIST-DISARTICULATION-STUMP-REMODELING

CPT 25922: Wrist Disarticulation Stump Remodeling

CPT-25924-FOREARM-STUMP-REVISION-POST-DISARTICULATION

CPT 25924: Forearm Stump Revision After Wrist Disarticulation

CPT-25927-HAND-AND-FINGER-AMPUTATION-AT-METACARPAL-LEVEL

CPT 25927: Hand and Finger Amputation at Metacarpal Level

CPT-25929-HAND-STUMP-REMODELING-TRANSMETACARPAL-AMPUTATION-REVISION

CPT 25929: Stump Remodeling After Transmetacarpal Amputation

CPT-25931-HAND-AMPUTATION-REVISION

CPT 25931: Revision Amputation Through Hand Bones

References

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.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.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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced Services	Use when the stump revision is partially reduced from the typical service (e.g., limited bone resection or scope reduced).
`53`	Discontinued Procedure	Use when the procedure is started but discontinued due to extenuating circumstances prior to completing the planned resection.
`54`	Surgical Care Only	Use when reporting only the surgeon's intraoperative service and another provider bills pre/postoperative care.
`55`	Postoperative Management Only	Use when only postoperative care related to the amputation revision is provided by the billing provider.
`62`	Two Surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the stump revision.
`66`	Surgical Team	Use when a surgical team approach is required for complex stump reconstruction.
`78`	Return to OR for Unrelated Procedure During Global Period	Use for a return to the operating room for a related complication during the global period when appropriate per payer rules.
`79`	Unrelated Procedure or Service by the Same Physician During the Postoperative Period	Use when an unrelated procedure is performed during the global period (note: `79` is not in the provided list; do not use).
`RT`	Right Side	Use to indicate the procedure was performed on the right radius/ulna stump.
`LT`	Left Side	Use to indicate the procedure was performed on the left radius/ulna stump.

Taxonomy Code	Specialty	Notes
208000000X	Orthopedic Surgery	Orthopedic surgeons commonly perform upper extremity stump revisions and bone shortening.
207P00000X	Plastic Surgery	Plastic surgeons perform soft tissue management and complex stump reconstruction for prosthetic fitting.
208600000X	Hand Surgery (Orthopedic)	Hand/upper extremity specialists focus on distal radius/ulna stump contouring and prosthetic optimization.
2084P0800X	Physical Medicine & Rehabilitation	Physiatrists coordinate functional outcomes and prosthetic planning pre/post revision.
3336C0003X	General Surgery	General surgeons may perform stump revisions in trauma or resource-limited settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement; subcutaneous tissue (includes removal of necrotic tissue and tissue prep)	May be performed before or during stump revision when infected or necrotic soft tissue requires debridement to achieve a healthy wound bed.
`26165`	Revision amputation, forearm; through radius and ulna (separate procedure for significant revision)	Related higher-complexity forearm revision when more extensive bone and soft tissue reconstruction is required beyond simple shortening.
`20680`	Removal of implant; deep (e.g., plates, screws)	Performed if prior internal fixation hardware at the distal stump must be removed to allow adequate shortening or infection management.
`11043`	Debridement; deep tissues, muscle and/or fascia, and/or bone	Used when debridement extends to deeper structures or bone during management of osteomyelitis in the stump.
`99024`	Postoperative follow-up visit global period included (hospital)	Used for reporting routine postoperative follow-up visits that fall within the global period after stump revision.

Related Codes

CPT-25900-FOREARM-AMPUTATION-CLOSURE

CPT 25900: Forearm Amputation with Closure

CPT-25905-FOREARM-AMPUTATION-CIRCUMFERENTIAL-BONE-TRANSECTION

CPT 25905: Circumferential Forearm Transection for Infection Control

CPT-25907-FOREARM-AMPUTATION-RESIDUAL-LIMB-REVISION

CPT 25907: Forearm Residual Limb Remodeling

CPT-25915-FOREARM-STUMP-PINCER-GRASP-RECONSTRUCTION

CPT 25915: Forearm Stump Pincer-Grasp Reconstruction

CPT-25920-WRIST-LEVEL-HAND-AMPUTATION

CPT 25920: Surgical Separation of Hand at Wrist

CPT-25922-WRIST-DISARTICULATION-STUMP-REMODELING

CPT 25922: Wrist Disarticulation Stump Remodeling

CPT-25924-FOREARM-STUMP-REVISION-POST-DISARTICULATION

CPT 25924: Forearm Stump Revision After Wrist Disarticulation

CPT-25927-HAND-AND-FINGER-AMPUTATION-AT-METACARPAL-LEVEL

CPT 25927: Hand and Finger Amputation at Metacarpal Level

CPT-25929-HAND-STUMP-REMODELING-TRANSMETACARPAL-AMPUTATION-REVISION

CPT 25929: Stump Remodeling After Transmetacarpal Amputation

CPT-25931-HAND-AMPUTATION-REVISION

CPT 25931: Revision Amputation Through Hand Bones

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.