CPT code 25624: Scaphoid fracture care, with manipulation2026 Medicare rate & RVUs in Montana
Reports closed treatment of a carpal scaphoid fracture when the clinician manipulates the fracture to restore alignment without open fixation.
In Montana, Medicare pays $549.04 for 25624 in the office and $446.17 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 25624 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 25624 covers
An orthopedic or hand surgeon treats a scaphoid fracture through the skin, using external maneuvers to realign the broken carpal bone. This service is typically used when fracture alignment requires manipulation and the clinician can treat the injury without surgically exposing the fracture or placing internal fixation. Immobilization in a cast or splint commonly follows the reduction.
Choose this code when the record identifies a scaphoid fracture and supports manipulation as part of the closed treatment; simple immobilization without manipulation points to a different code. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery are 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.
How Montana compares for 25624
Across 109 of 109 payment localities, the office rate for 25624 runs from $482.10 in Arkansas to $709.99 in San Benito County, CA. Montana pays $549.04. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$549.04
- Los Angeles, CA · California$610.21+$61.17
- Washington, DC area · District of Columbia$625.42+$76.38
- Miami, FL · Florida$614.96+$65.92
- Chicago, IL · Illinois$595.25+$46.21
- Manhattan, NY · New York$637.01+$87.97
- Alaska · Alaska$635.20+$86.16
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $489.57 | $399.55 |
| ArkansasArkansas | $482.10 | $393.73 |
| ArizonaArizona | $533.13 | $433.44 |
| Bakersfield, CACalifornia | $573.60 | $460.85 |
| Chico, CACalifornia | $570.85 | $458.10 |
| El Centro, CACalifornia | $571.02 | $458.27 |
| Fresno, CACalifornia | $570.85 | $458.10 |
| Hanford, CACalifornia | $570.85 | $458.10 |
| Madera, CACalifornia | $570.85 | $458.10 |
| Merced, CACalifornia | $570.85 | $458.10 |
| Modesto, CACalifornia | $570.85 | $458.10 |
| Napa, CACalifornia | $657.07 | $521.48 |
| Oxnard, CACalifornia | $606.46 | $484.86 |
| Redding, CACalifornia | $570.85 | $458.10 |
| Rest of CaliforniaCalifornia | $570.85 | $458.10 |
| Riverside, CACalifornia | $581.59 | $468.84 |
| Sacramento, CACalifornia | $597.95 | $478.31 |
| Salinas, CACalifornia | $595.73 | $476.50 |
| San Diego, CACalifornia | $609.11 | $486.07 |
| Marin County, CACalifornia | $693.56 | $548.50 |
| San Francisco, CACalifornia | $692.42 | $547.37 |
| San Benito County, CACalifornia | $709.99 | $561.65 |
| Santa Clara County, CACalifornia | $705.35 | $557.00 |
| San Luis Obispo, CACalifornia | $586.35 | $469.17 |
| Santa Cruz, CACalifornia | $614.36 | $489.37 |
| Santa Maria, CACalifornia | $597.79 | $477.84 |
| Santa Rosa, CACalifornia | $620.44 | $494.11 |
| Stockton, CACalifornia | $570.85 | $458.10 |
| Vallejo, CACalifornia | $655.43 | $519.84 |
| Visalia, CACalifornia | $570.85 | $458.10 |
| Yuba City, CACalifornia | $570.85 | $458.10 |
| ColoradoColorado | $566.73 | $457.27 |
| ConnecticutConnecticut | $586.98 | $476.19 |
| DelawareDelaware | $542.19 | $440.55 |
| Fort Lauderdale, FLFlorida | $580.78 | $476.57 |
| Rest of FloridaFlorida | $550.05 | $451.71 |
| Atlanta, GAGeorgia | $562.06 | $457.54 |
| Rest of GeorgiaGeorgia | $516.60 | $424.84 |
| Hawaii, Guam, HIHawaii | $584.42 | $467.45 |
| IowaIowa | $498.34 | $404.21 |
| IdahoIdaho | $502.68 | $408.03 |
| East St. Louis, ILIllinois | $554.15 | $459.50 |
| Rest of IllinoisIllinois | $536.56 | $442.64 |
| Suburban Chicago, ILIllinois | $585.71 | $480.06 |
| IndianaIndiana | $505.63 | $410.27 |
| KansasKansas | $497.95 | $404.95 |
| KentuckyKentucky | $506.27 | $414.81 |
| New Orleans, LALouisiana | $532.39 | $435.58 |
| Rest of LouisianaLouisiana | $506.26 | $415.22 |
| Metropolitan Boston, MAMassachusetts | $621.72 | $498.89 |
| Rest of MassachusettsMassachusetts | $563.92 | $455.59 |
| Baltimore area, MDMaryland | $585.82 | $475.44 |
| Rest of MarylandMaryland | $552.25 | $448.14 |
| Rest of MaineMaine | $507.65 | $413.01 |
| Southern Maine, MEMaine | $533.54 | $431.59 |
| Detroit, MIMichigan | $559.41 | $460.14 |
| Rest of MichiganMichigan | $522.07 | $428.14 |
| MinnesotaMinnesota | $536.05 | $430.19 |
| Metropolitan Kansas City, MOMissouri | $526.36 | $429.76 |
| Metropolitan St. Louis, MOMissouri | $531.88 | $433.94 |
| Rest of MissouriMissouri | $498.51 | $409.83 |
| MississippiMississippi | $490.30 | $401.72 |
| North CarolinaNorth Carolina | $512.91 | $416.92 |
| North DakotaNorth Dakota | $529.27 | $426.40 |
| NebraskaNebraska | $500.58 | $405.63 |
| New HampshireNew Hampshire | $559.71 | $452.62 |
| Northern New JerseyNew Jersey | $618.83 | $499.50 |
| Rest of New JerseyNew Jersey | $591.72 | $479.38 |
| New MexicoNew Mexico | $525.91 | $431.58 |
| NevadaNevada | $543.89 | $440.92 |
| NYC suburbs and Long Island, NYNew York | $655.79 | $533.47 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $597.35 | $484.70 |
| Queens, NYNew York | $639.41 | $517.81 |
| Rest of New YorkNew York | $521.17 | $423.44 |
| OhioOhio | $518.02 | $424.10 |
| OklahomaOklahoma | $503.10 | $411.23 |
| Portland, OROregon | $583.05 | $468.76 |
| Rest of OregonOregon | $537.75 | $435.29 |
| Metropolitan Philadelphia, PAPennsylvania | $573.13 | $466.04 |
| Rest of PennsylvaniaPennsylvania | $517.72 | $423.28 |
| Puerto RicoPuerto Rico | $552.57 | $448.57 |
| Rhode IslandRhode Island | $560.35 | $454.08 |
| South CarolinaSouth Carolina | $516.71 | $421.65 |
| South DakotaSouth Dakota | $526.93 | $424.06 |
| TennesseeTennessee | $500.85 | $407.34 |
| Austin, TXTexas | $566.52 | $457.68 |
| Beaumont, TXTexas | $514.30 | $420.69 |
| Brazoria, TXTexas | $539.76 | $437.81 |
| Dallas, TXTexas | $544.32 | $441.86 |
| Fort Worth, TXTexas | $541.15 | $439.72 |
| Galveston, TXTexas | $542.09 | $439.93 |
| Houston, TXTexas | $560.39 | $458.23 |
| Rest of TexasTexas | $527.49 | $429.86 |
| UtahUtah | $524.08 | $427.38 |
| VirginiaVirginia | $533.16 | $432.04 |
| Virgin Islands, VIUnited States Virgin Islands | $552.57 | $448.57 |
| VermontVermont | $529.01 | $427.16 |
| Rest of WashingtonWashington | $562.25 | $453.92 |
| King County, WAWashington | $632.57 | $506.35 |
| WisconsinWisconsin | $510.86 | $412.31 |
| West VirginiaWest Virginia | $516.29 | $426.90 |
| WyomingWyoming | $540.43 | $437.55 |
25624 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$482.10
$640.42
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $635.20 | 1 |
| AL | $489.57 | 1 |
| AR | $482.10 | 1 |
| AZ | $533.13 | 1 |
| CA | $570.85–$709.99 | 29 |
| CO | $566.73 | 1 |
| CT | $586.98 | 1 |
| DC | $625.42 | 1 |
| DE | $542.19 | 1 |
| FL | $550.05–$614.96 | 3 |
| GA | $516.60–$562.06 | 2 |
| GU | $584.42 | 1 |
| HI | $584.42 | 1 |
| IA | $498.34 | 1 |
| ID | $502.68 | 1 |
| IL | $536.56–$595.25 | 4 |
| IN | $505.63 | 1 |
| KS | $497.95 | 1 |
| KY | $506.27 | 1 |
| LA | $506.26–$532.39 | 2 |
| MA | $563.92–$621.72 | 2 |
| MD | $552.25–$625.42 | 3 |
| ME | $507.65–$533.54 | 2 |
| MI | $522.07–$559.41 | 2 |
| MN | $536.05 | 1 |
| MO | $498.51–$531.88 | 3 |
| MS | $490.30 | 1 |
| MT | $549.04 | 1 |
| NC | $512.91 | 1 |
| ND | $529.27 | 1 |
| NE | $500.58 | 1 |
| NH | $559.71 | 1 |
| NJ | $591.72–$618.83 | 2 |
| NM | $525.91 | 1 |
| NV | $543.89 | 1 |
| NY | $521.17–$655.79 | 5 |
| OH | $518.02 | 1 |
| OK | $503.10 | 1 |
| OR | $537.75–$583.05 | 2 |
| PA | $517.72–$573.13 | 2 |
| PR | $552.57 | 1 |
| RI | $560.35 | 1 |
| SC | $516.71 | 1 |
| SD | $526.93 | 1 |
| TN | $500.85 | 1 |
| TX | $514.30–$566.52 | 8 |
| UT | $524.08 | 1 |
| VA | $533.16–$625.42 | 2 |
| VI | $552.57 | 1 |
| VT | $529.01 | 1 |
| WA | $562.25–$632.57 | 2 |
| WI | $510.86 | 1 |
| WV | $516.29 | 1 |
| WY | $540.43 | 1 |
How the 25624 rate is calculated
Each of 25624’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.
How the rate is built · 25624
RVUs × geographic indexes × conversion factor
Work4.65
4.65 RVUs× 1.000 GPCI
Practice expense10.79
10.79 RVUs× 1.000 GPCI
Malpractice1.00
1.00 RVUs× 1.000 GPCI
Adjusted RVUs
16.4400
Conversion factor
$33.4009
Medicare rate
$549.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,492
- Code
- 25624
- Physician work
- 4.65
- Practice expense
- 10.79
- Malpractice
- 1.00
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.65 | × 1.000 | 4.6500 |
| Practice expense | 10.79 | × 1.000 | 10.7900 |
| Malpractice | 1.00 | × 0.998 | 0.9980 |
| Total RVUs | 16.4380 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$549.04
Office: (4.65 × 1 + 10.79 × 1 + 1 × 0.998) × $33.4009 = $549.04
Facility: (4.65 × 1 + 7.71 × 1 + 1 × 0.998) × $33.4009 = $446.17
Payment rules and modifiers for 25624
25624 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25624
Scaphoid fracture care, with manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25624
Scaphoid fracture care, with manipulation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25624 without 50 · national office
$549.11
Scaphoid fracture care, with manipulation
25624-50 · Bilateral: 150%
$823.67
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 25624 has changed in Montana
25624 · Office / nonfacility
$549.04
Effective 2026-10-01
The base rate is $49.01 higher than on 2025-10-01, moving from $500.03 to $549.04 (9.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$500.03changed to$549.04
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.77 changed to 4.65
- Practice expense RVU 9.73 changed to 10.79
- Malpractice RVU 0.98 changed to 1.00
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$509.24changed to$500.03
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.56 changed to 9.73
- Malpractice RVU 0.99 changed to 0.98
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$500.93changed to$509.24
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$509.63changed to$500.93
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.33 changed to 9.56
- Malpractice RVU 0.96 changed to 0.99
January 1, 2023
RVU23A
$510.35changed to$509.63
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.01 changed to 9.33
- Malpractice RVU 0.99 changed to 0.96
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$506.93changed to$510.35
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.83 changed to 9.01
- Malpractice RVU 0.95 changed to 0.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$511.49changed to$506.93
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.19 changed to 8.83
- Malpractice RVU 0.93 changed to 0.95
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$520.35changed to$511.49
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.07 changed to 8.19
- Malpractice RVU 0.98 changed to 0.93
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$518.00changed to$520.35
- Malpractice RVU 0.94 changed to 0.98
Held through RVU19D.
January 1, 2019
RVU19A
$516.67changed to$518.00
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.00 changed to 8.07
- Malpractice RVU 0.97 changed to 0.94
Held through RVU19B.
January 1, 2018
RVU18AR1
$501.79changed to$516.67
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.84 changed to 8.00
- Malpractice RVU 0.96 changed to 0.97
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$492.40changed to$501.79
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 7.83 changed to 7.84
- Malpractice RVU 0.94 changed to 0.96
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$500.05changed to$492.40
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 7.92 changed to 7.83
- Malpractice RVU 1.00 changed to 0.94
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$497.56changed to$500.05
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$486.07changed to$497.56
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 7.82 changed to 7.92
- Malpractice RVU 0.84 changed to 1.00
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$488.93changed to$486.07
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 8.63 changed to 7.82
- Malpractice RVU 0.88 changed to 0.84
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $488.93
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $549.04 | $446.17 | RVU26D |
| 2026-07-01 | $549.04 | $446.17 | RVU26C |
| 2026-04-01 | $549.04 | $446.17 | RVU26B |
| 2026-01-01 | $549.04 | $446.17 | RVU26A |
| 2025-10-01 | $500.03 | $452.80 | RVU25D |
| 2025-07-01 | $500.03 | $452.80 | RVU25C |
| 2025-04-01 | $500.03 | $452.80 | RVU25B |
| 2025-01-01 | $500.03 | $452.80 | RVU25A |
| 2024-10-01 | $509.24 | $460.64 | RVU24D |
| 2024-07-01 | $509.24 | $460.64 | RVU24C |
| 2024-04-01 | $509.24 | $460.64 | RVU24B |
| 2024-03-09 | $509.24 | $460.64 | RVU24AR |
| 2024-01-01 | $500.93 | $453.12 | RVU24A |
| 2023-10-01 | $509.63 | $461.51 | RVU23D |
| 2023-07-01 | $509.63 | $461.51 | RVU23C |
| 2023-04-01 | $509.63 | $461.51 | RVU23B |
| 2023-01-01 | $509.63 | $461.51 | RVU23A |
| 2022-10-01 | $510.35 | $462.24 | RVU22D |
| 2022-07-01 | $510.35 | $462.24 | RVU22C |
| 2022-04-01 | $510.35 | $462.24 | RVU22B |
| 2022-01-01 | $510.35 | $462.24 | RVU22A |
| 2021-10-01 | $506.93 | $458.78 | RVU21D |
| 2021-07-01 | $506.93 | $458.78 | RVU21C |
| 2021-04-01 | $506.93 | $458.78 | RVU21B |
| 2021-01-01 | $506.93 | $458.78 | RVU21A |
| 2020-10-01 | $511.49 | $466.01 | RVU20D |
| 2020-07-01 | $511.49 | $466.01 | RVU20C |
| 2020-04-01 | $511.49 | $466.01 | RVU20B |
| 2020-01-01 | $511.49 | $466.01 | RVU20A |
| 2019-10-01 | $520.35 | $475.30 | RVU19D |
| 2019-07-01 | $520.35 | $475.30 | RVU19C |
| 2019-04-01 | $518.00 | $472.95 | RVU19B |
| 2019-01-01 | $518.00 | $472.95 | RVU19A |
| 2018-10-01 | $516.67 | $471.67 | RVU18D |
| 2018-07-01 | $516.67 | $471.67 | RVU18C |
| 2018-04-01 | $516.67 | $471.67 | RVU18B |
| 2018-01-01 | $516.67 | $471.67 | RVU18AR1 |
| 2017-10-01 | $501.79 | $459.44 | RVU17D |
| 2017-07-01 | $501.79 | $459.44 | RVU17C |
| 2017-04-01 | $501.79 | $459.44 | RVU17B |
| 2017-01-01 | $501.79 | $459.44 | RVU17A |
| 2016-10-01 | $492.40 | $450.15 | RVU16D |
| 2016-07-01 | $492.40 | $450.15 | RVU16C |
| 2016-04-01 | $492.40 | $450.15 | RVU16B |
| 2016-01-01 | $492.40 | $450.15 | RVU16A |
| 2015-10-01 | $500.05 | $456.21 | RVU15D |
| 2015-07-01 | $500.05 | $456.21 | RVU15C |
| 2015-04-01 | $497.56 | $453.94 | RVU15B |
| 2015-01-01 | $497.56 | $453.94 | RVU15A |
| 2014-10-01 | $486.07 | $443.79 | RVU14D |
| 2014-07-01 | $486.07 | $443.79 | RVU14C |
| 2014-04-01 | $486.07 | $443.79 | RVU14B |
| 2014-01-01 | $486.07 | $443.79 | RVU14A |
| 2013-10-01 | $488.93 | $444.02 | RVU13D |
| 2013-07-01 | $488.93 | $444.02 | RVU13C |
| 2013-04-01 | $488.93 | $444.02 | RVU13B |
| 2013-01-01 | $488.93 | $444.02 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
25624 billing questions
When should I choose 25624 instead of 25622?
Use 25624 when the clinician manipulates the scaphoid fracture during closed treatment. Code 25622 describes closed scaphoid fracture treatment without manipulation.
How does 25624 differ from 25628?
25624 is closed treatment with manipulation. Use 25628 when the scaphoid fracture is treated openly with internal fixation.
What documentation supports 25624?
Document the scaphoid fracture, the closed reduction or manipulation performed, and the treatment plan, including immobilization when used. The record should distinguish manipulation from immobilization alone.
Are routine follow-up visits included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral treatment reported?
When the service is performed bilaterally, CMS pays 150% with modifier 50. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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
Show the CMS file lines behind this rate
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