Orthopedics CPT Codes and Modifiers for 2025
Mar 11, 2025
Orthopedic billing is complex due to the wide range of services—from E/M visits and injections to imaging, fracture care, and surgery. To prevent claim denials and ensure full reimbursement, practices must stay current with Orthopedic CPT codes and modifiers for 2025.
This guide covers essential orthopedic billing codes, common modifiers, and ICD-10 pairings to help your team stay compliant and efficient.
Evaluation & Management (E/M) Codes
| CPT Code | Description |
|---|---|
| 99202–99205 | New patient office visit (levels 2–5) |
| 99212–99215 | Established patient office visit (levels 2–5) |
| 99221–99223 | Initial hospital care |
| 99231–99233 | Subsequent hospital care |
| 99238–99239 | Hospital discharge |
| 99456 | Work-related or medical disability exam (e.g., IME) |
Injections, Aspiration, and Fracture Care
| CPT Code | Description |
|---|---|
| 20610 | Arthrocentesis of major joint (e.g., knee, shoulder) |
| 20605 | Aspiration/injection of intermediate joint |
| 20600 | Aspiration/injection of small joint |
| 20550 | Injection of tendon sheath or ligament |
| 29075 | Application of long arm cast |
| 29085 | Application of forearm cast |
| 29125 | Short arm splint |
| 29130 | Long arm splint |
| 29345 | Long leg cast |
| 29355 | Short leg cast |
| 29405 | Short leg splint |
Orthopedic Surgeries
| CPT Code | Description |
|---|---|
| 29881 | Knee arthroscopy with meniscectomy |
| 29888 | Knee arthroscopy with ACL reconstruction |
| 23410 | Repair of rotator cuff |
| 23472 | Total shoulder arthroplasty |
| 27130 | Total hip replacement |
| 27447 | Total knee arthroplasty |
| 25607–25609 | ORIF of distal radius fractures |
| 27786 | Closed treatment of ankle fracture |
| 27792 | ORIF of ankle fracture |
Common Modifiers in Orthopedic Billing
| Modifier | Description |
|---|---|
| -25 | Significant, separately identifiable E/M service on same day |
| -57 | Decision for surgery made during E/M |
| -50 | Bilateral procedure |
| -LT / -RT | Left or right side |
| -54 | Surgical care only |
| -55 | Post-op care only |
| -59 | Distinct procedural service |
| -76 | Repeat procedure by same provider |
| -58 | Staged/related procedure during post-op |
Common ICD-10 Codes in Orthopedics
| ICD-10 Code | Description |
|---|---|
| M17.11 | Osteoarthritis of right knee |
| M75.101 | Unspecified rotator cuff tear |
| S83.241A | Bucket-handle tear of meniscus, right knee |
| S82.301A | Fracture of right tibia shaft |
| M16.11 | Osteoarthritis of right hip |
| M54.5 | Low back pain |
| M51.26 | Disc displacement, lumbar |
Orthopedic Coding Tips for 2025
Final Thoughts
Orthopedic coding requires precision, especially when managing surgery, injections, and casting. With the correct Orthopedic CPT codes and modifiers for 2025, your team can streamline billing and reduce audit risk—while ensuring you’re fully reimbursed for the care you provide.
For informational purposes only.
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