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CPT code 25630: Carpal fracture care, without manipulation, each bone2026 Medicare rate & RVUs in Chicago, IL

Reports closed treatment of a carpal bone fracture other than the scaphoid when the physician treats the fracture without manipulating it.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Chicago, IL, Medicare pays $371.94 for 25630 in the office and $317.23 when it’s performed in a hospital or facility.

$371.94Office (non-facility)
$317.23Hospital or facility
+7.8%vs the national office rate ($345.03)

Check a contract rate as a % of Medicare · 25630 nationwide

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

We’ll open 25630 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 25630 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 25630 covers

This service covers closed treatment of a fractured carpal bone other than the scaphoid, without manipulation of the fracture. A hand or orthopedic surgeon commonly provides it for injuries such as a triquetral or hamate fracture, using immobilization and clinical follow-up rather than operative fixation. Treatment may occur in an office, emergency department, or facility setting. The code is reported for each carpal bone treated.

Choose this code when documentation identifies a non-scaphoid carpal fracture and supports treatment without manipulation. Record the injured bone, the treatment plan, and the fracture care provided; use the manipulation code when the physician manipulates the fracture, and the scaphoid-specific code for a scaphoid fracture. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 Chicago, IL compares for 25630

Across 109 of 109 payment localities, the office rate for 25630 runs from $303.61 in Arkansas to $447.27 in San Benito County, CA. Chicago, IL pays $371.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

25630 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$371.94
  2. East St. Louis, IL · Illinois$346.50−$25.44
  3. Rest of Illinois · Illinois$336.18−$35.76
  4. Suburban Chicago, IL · Illinois$366.81−$5.13
  5. Los Angeles, CA · California$384.13+$12.19
  6. Washington, DC area · District of Columbia$392.97+$21.03
  7. Miami, FL · Florida$383.96+$12.02

Other areas in Illinois first, then benchmark localities. Bars start at $0.

Every other payment area

25630 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$399.48$336.22
AlaskaAlaska$400.36$342.38
AlabamaAlabama$308.23$260.59
ArkansasArkansas$303.61$256.84
ArizonaArizona$335.20$282.45
Bakersfield, CACalifornia$361.13$301.46
Chico, CACalifornia$359.52$299.85
El Centro, CACalifornia$359.62$299.95

25630 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$303.61

$403.40

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
25630 office rate range by state
State / territoryOffice rate rangeLocalities
AK$400.361
AL$308.231
AR$303.611
AZ$335.201
CA$359.52–$447.2729
CO$356.511
CT$368.561
DC$392.971
DE$340.841
FL$344.78–$383.963
GA$324.22–$352.852
GU$367.991
HI$367.991
IA$314.041
ID$316.651
IL$336.18–$371.944
IN$318.491
KS$313.621
KY$318.171
LA$318.10–$334.272
MA$354.71–$391.002
MD$347.15–$392.973
ME$319.54–$335.842
MI$327.77–$350.372
MN$337.981
MO$313.18–$334.173
MS$308.401
MT$344.991
NC$322.821
ND$333.521
NE$315.491
NH$351.921
NJ$371.75–$388.902
NM$330.071
NV$342.021
NY$327.92–$410.875
OH$325.431
OK$316.411
OR$338.37–$366.862
PA$325.34–$359.862
PR$347.241
RI$352.311
SC$324.861
SD$332.171
TN$315.391
TX$323.21–$356.198
UT$329.431
VA$335.47–$392.972
VI$347.241
VT$333.191
WA$353.72–$397.972
WI$322.091
WV$323.631
WY$339.991

See 25630 in every payment locality

How the 25630 rate is calculated

Each of 25630’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 · 25630

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.95

2.95 RVUs× 1.000 GPCI

Practice expense6.80

6.80 RVUs× 1.000 GPCI

Malpractice0.58

0.58 RVUs× 1.000 GPCI

Adjusted RVUs

10.3300

Conversion factor

$33.4009

Medicare rate

$345.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,494

Code
25630
Physician work
2.95
Practice expense
6.80
Malpractice
0.58

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 25630 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work2.95× 1.0072.9707
Practice expense6.80× 1.0056.8340
Malpractice0.58× 2.2951.3311
Total RVUs11.1357
Conversion factor× 33.4009

Office rate, Chicago, IL$371.94

Office: (2.95 × 1.007 + 6.8 × 1.005 + 0.58 × 2.295) × $33.4009 = $371.94

Facility: (2.95 × 1.007 + 5.17 × 1.005 + 0.58 × 2.295) × $33.4009 = $317.23

Open 25630 in the RVU calculator

Payment rules and modifiers for 25630

25630 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25630

Carpal fracture care, without manipulation, each bone

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25630

Carpal fracture care, without manipulation, each bone

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25630 without 50 · national office

$345.03

Carpal fracture care, without manipulation, each bone

25630-50 · Bilateral: 150%

$517.55

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).

When to use modifier 50

Codes related to 25630

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

Codes related to 25630
CodeHow it relatesOffice range, Chicago, IL
Same family
25635Carpal fracture treatment, with manipulation, each boneClosed treatment of a non-scaphoid carpal fracture when manipulation is performed.$564.99
Used instead
25622Scaphoid fracture care, without manipulationClosed treatment without manipulation when the fractured carpal bone is the scaphoid.$375.91
25624Scaphoid fracture care, with manipulationClosed treatment with manipulation for a scaphoid fracture.$595.25
25645Carpal fracture repair, other than scaphoid, each boneOpen treatment for a non-scaphoid carpal fracture.No office rate
25628Scaphoid fixation, open treatment with fixationOpen treatment with internal fixation for a scaphoid fracture.No office rate

How 25630 has changed in Chicago, IL

25630 · Office / nonfacility

$371.94

Effective 2026-10-01

The base rate is $32.88 higher than on 2025-10-01, moving from $339.06 to $371.94 (9.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $339.06changed to$371.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.03 changed to 2.95
    • Practice expense RVU 6.10 changed to 6.80
    • Malpractice RVU 0.59 changed to 0.58
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $344.17changed to$339.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.98 changed to 6.10
    • Malpractice RVU 0.58 changed to 0.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $338.55changed to$344.17

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $345.91changed to$338.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.83 changed to 5.98
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018

  5. January 1, 2023

    RVU23A

    $345.24changed to$345.91

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.60 changed to 5.83
    • Malpractice RVU 0.57 changed to 0.58
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $344.17changed to$345.24

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.51 changed to 5.60
    • Malpractice RVU 0.56 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $342.93changed to$344.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.18 changed to 5.51
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $337.37changed to$342.93

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.15 changed to 5.18
    • Malpractice RVU 0.51 changed to 0.56
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $340.29changed to$337.37

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.22 changed to 5.15
    • Malpractice RVU 0.52 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $337.92changed to$340.29

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.12 changed to 5.22
    • Malpractice RVU 0.53 changed to 0.52
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $338.27changed to$337.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.11 changed to 5.12
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $339.86changed to$338.27

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.12 changed to 5.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $338.17changed to$339.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $339.52changed to$338.17

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.05 changed to 5.12
    • Malpractice RVU 0.54 changed to 0.53
    • Work GPCI 1.023 changed to 1.016
    • Practice expense GPCI 1.044 changed to 1.037
    • Malpractice GPCI 2.048 changed to 2.019

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $345.64changed to$339.52

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.59 changed to 5.05
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.030 changed to 1.023
    • Practice expense GPCI 1.051 changed to 1.044
    • Malpractice GPCI 2.077 changed to 2.048

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$345.64

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$371.94$317.23RVU26D
2026-07-01$371.94$317.23RVU26C
2026-04-01$371.94$317.23RVU26B
2026-01-01$371.94$317.23RVU26A
2025-10-01$339.06$316.56RVU25D
2025-07-01$339.06$316.56RVU25C
2025-04-01$339.06$316.56RVU25B
2025-01-01$339.06$316.56RVU25A
2024-10-01$344.17$321.01RVU24D
2024-07-01$344.17$321.01RVU24C
2024-04-01$344.17$321.01RVU24B
2024-03-09$344.17$321.01RVU24AR
2024-01-01$338.55$315.77RVU24A
2023-10-01$345.91$322.46RVU23D
2023-07-01$345.91$322.46RVU23C
2023-04-01$345.91$322.46RVU23B
2023-01-01$345.91$322.46RVU23A
2022-10-01$345.24$321.75RVU22D
2022-07-01$345.24$321.75RVU22C
2022-04-01$345.24$321.75RVU22B
2022-01-01$345.24$321.75RVU22A
2021-10-01$344.17$320.13RVU21D
2021-07-01$344.17$320.13RVU21C
2021-04-01$344.17$320.13RVU21B
2021-01-01$344.17$320.13RVU21A
2020-10-01$342.93$318.93RVU20D
2020-07-01$342.93$318.93RVU20C
2020-04-01$342.93$318.93RVU20B
2020-01-01$342.93$318.93RVU20A
2019-10-01$337.37$313.14RVU19D
2019-07-01$337.37$313.14RVU19C
2019-04-01$337.37$313.14RVU19B
2019-01-01$337.37$313.14RVU19A
2018-10-01$340.29$312.75RVU18D
2018-07-01$340.29$312.75RVU18C
2018-04-01$340.29$312.75RVU18B
2018-01-01$340.29$312.75RVU18AR1
2017-10-01$337.92$312.27RVU17D
2017-07-01$337.92$312.27RVU17C
2017-04-01$337.92$312.27RVU17B
2017-01-01$337.92$312.27RVU17A
2016-10-01$338.27$312.65RVU16D
2016-07-01$338.27$312.65RVU16C
2016-04-01$338.27$312.65RVU16B
2016-01-01$338.27$312.65RVU16A
2015-10-01$339.86$313.40RVU15D
2015-07-01$339.86$313.40RVU15C
2015-04-01$338.17$311.84RVU15B
2015-01-01$338.17$311.84RVU15A
2014-10-01$339.52$313.72RVU14D
2014-07-01$339.52$313.72RVU14C
2014-04-01$339.52$313.72RVU14B
2014-01-01$339.52$313.72RVU14A
2013-10-01$345.64$318.11RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 25630 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

25630 billing questions

How does this differ from 25635?

Use 25630 when the non-scaphoid carpal fracture is treated without manipulation. Use 25635 when the physician manipulates the fracture as part of closed treatment.

Can 25630 be used for a scaphoid fracture?

No. The scaphoid has its own closed-treatment codes: 25622 without manipulation and 25624 with manipulation.

How many units should be reported?

The code is reported for each carpal bone treated. Documentation should identify each treated bone when more than one is involved.

Are routine fracture follow-up visits separately reported?

Related postoperative care during the 90-day global period is included. The global also includes the day-before preoperative visit.

How is bilateral treatment handled?

For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon or co-surgeon be billed?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

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
RVUs for 25630PPRRVU2026_Oct_nonQPP.csv, line 2,494 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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