CPT code 25628: Scaphoid fixation, open treatment with fixation2026 Medicare rate & RVUs

Medicare pays $669.02 for 25628 nationally in a facility.

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

What 25628 covers

An orthopedic or hand surgeon uses an open approach to expose and treat a fractured scaphoid, a carpal bone on the thumb side of the wrist. The surgeon restores fracture alignment as needed and stabilizes the bone with internal fixation, such as a screw. This treatment is commonly performed in an operating room for a displaced or unstable scaphoid fracture when operative fixation is selected.

Report 25628 when the operative record supports open treatment of the scaphoid fracture with internal fixation; closed management or treatment of a different carpal bone calls for a different code. Document the fracture site, operative approach, reduction or alignment work, and fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.

Where 25628 pays more and less

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

109 of 109 payment localities

25628 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 25628 rate is calculated

Each of 25628’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 25628

25628 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

25628 compared with similar codes

How to choose

25622Scaphoid fracture careWithout manipulation

25622 is closed treatment of a scaphoid fracture without manipulation. Use 25628 when the surgeon opens the site and stabilizes the fracture with internal fixation.

25624Scaphoid fracture careWith manipulation

25624 is closed treatment of a scaphoid fracture with manipulation. It does not represent open fixation as reported with 25628.

25440Scaphoid repairNonunion repair

25440 addresses repair of an established scaphoid nonunion or malunion. 25628 describes open fixation of a scaphoid fracture, not reconstruction of a nonunion or malunion.

25645Carpal fracture repairOther than scaphoid, each bone

25645 is open treatment of a carpal fracture in a bone other than the scaphoid. 25628 is specific to the scaphoid.

Codes related to 25628

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