CPT code 25431: Carpal bone repair, nonunion, excluding scaphoid2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 25431 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 25431 covers

This code describes operative repair of a carpal bone that has failed to unite, excluding the scaphoid. The surgeon addresses the persistent nonunion and may use internal fixation; the code covers repair whether or not fixation is used. It is distinct from treatment directed at a scaphoid nonunion and from procedures on the radius or ulna. These operations are generally performed by orthopedic or hand surgeons in a surgical setting.

Report the code when the operative target is a nonunion of a non-scaphoid carpal bone. The operative report should identify the bone and document the nonunion and the repair performed, including fixation when used. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral repair, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 25431 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 25431 rate is calculated

Each of 25431’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 25431

25431 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

25431 compared with similar codes

How to choose

25440Scaphoid repairNonunion repair

Use 25431 for a nonunion in a carpal bone other than the scaphoid. Use 25440 when the nonunion is in the scaphoid.

25430Carpal bone graftVascularized graft

Code 25430 describes placement of a vascularized pedicle graft into a carpal bone. Code 25431 describes repair of a non-scaphoid carpal bone nonunion.

25405Forearm bone repairOne bone, autograft

Code 25405 addresses repair with grafting for a radius or ulna nonunion. Code 25431 applies to a non-scaphoid carpal bone.

Codes related to 25431

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates