CPT 25609 · Trauma / Fracture · Medicare (CGS MAC)
ORIF Distal Radius Fracture — Intra-articular, 3+ Fragment at Medicare (CGS MAC).
How Medicare (CGS MAC) approaches CPT 25609 (ORIF Distal Radius Fracture — Intra-articular, 3+ Fragment) for prior-authorization review: at last review on 2026-05-02, the policy covers this code without prior authorization.
Free with practitioner sign-in — magic-link email auth, no credit card.
Coverage
Covered
Prior auth
No prior auth
Last reviewed
2026-05-02
Criteria summary
High-level themes from the Medicare (CGS MAC) policy of record for CPT 25609. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
See the full Medicare (CGS MAC) criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →