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25035 Inc dp bone crtx f/arm&/wrst

What 25035 is

CMS fee schedule short descriptor: Inc dp bone crtx f/arm&/wrst.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 25035 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)7.467.821.5916.87$563.47
Facility (hospital, ASC)7.467.821.5916.87$563.47

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

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Medically Unlikely Edit (MUE)

Medicare caps 25035 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 25035? These codes are bundled into it

25035 is a Column 1 code in 255 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01810Anes px nrv musc f/arm wrst0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0707TNjx b1 sub mtrl sbchdrl dfct1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0869TNjx b1 sub mtrl hw fixj aug1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10030Img gid flu coll drg sft tis1 - modifier may bypassCheck pair
10060I&d abscess simple/single1 - modifier may bypassCheck pair
10061I&d abscess comp/multiple1 - modifier may bypassCheck pair
10140I&d hmtma seroma/fluid collj1 - modifier may bypassCheck pair
10160Pnxr aspir absc hmtma bulla1 - modifier may bypassCheck pair
11010Debride skin at fx site1 - modifier may bypassCheck pair
11011Debride skin musc at fx site1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair

Showing 30 of 255 column 2 codes. Use the pair checker for any specific combination.

25035 is bundled into these codes

25035 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 25035 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11012Deb skin bone at fx site1Check pair
25170Resect radius/ulnar tumor1Check pair
25337Reconstruct ulna/radioulnar1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.