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

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 North Carolina, Medicare pays $322.82 for 25630 in the office and $272.02 when it’s performed in a hospital or facility.

$322.82Office (non-facility)
$272.02Hospital or facility
−6.4%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 North Carolina
  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 North Carolina 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. North Carolina pays $322.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

25630 in North Carolina vs other payment areas
  1. North Carolina · this page$322.82
  2. Los Angeles, CA · California$384.13+$61.31
  3. Washington, DC area · District of Columbia$392.97+$70.15
  4. Miami, FL · Florida$383.96+$61.14
  5. Chicago, IL · Illinois$371.94+$49.12
  6. Manhattan, NY · New York$399.48+$76.66
  7. Alaska · Alaska$400.36+$77.54

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

Every other payment area

25630 in every other Medicare payment locality
Payment localityOfficeFacility
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
Fresno, CACalifornia$359.52$299.85
Hanford, CACalifornia$359.52$299.85

25630 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.

$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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 25630 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.95× 1.0002.9500
Practice expense6.80× 0.9336.3444
Malpractice0.58× 0.6390.3706
Total RVUs9.6650
Conversion factor× 33.4009

Office rate, North Carolina$322.82

Office: (2.95 × 1 + 6.8 × 0.933 + 0.58 × 0.639) × $33.4009 = $322.82

Facility: (2.95 × 1 + 5.17 × 0.933 + 0.58 × 0.639) × $33.4009 = $272.02

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

How 25630 has changed in North Carolina

25630 · Office / nonfacility

$322.82

Effective 2026-10-01

The base rate is $29.41 higher than on 2025-10-01, moving from $293.41 to $322.82 (10.0%).

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

    $293.41changed to$322.82

    • 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 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $298.03changed to$293.41

    • 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

    $293.16changed to$298.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $300.40changed to$293.16

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.83 changed to 5.98
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $300.85changed to$300.40

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $300.15changed to$300.85

    • 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

    $298.51changed to$300.15

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.18 changed to 5.51
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $294.77changed to$298.51

    • 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
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $297.04changed to$294.77

    • 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

    $293.74changed to$297.04

    • 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
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $293.21changed to$293.74

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.11 changed to 5.12
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $294.61changed to$293.21

    • 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

    $293.14changed to$294.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $290.76changed to$293.14

    • 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
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $292.64changed to$290.76

    • 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
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $292.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$322.82$272.02RVU26D
2026-07-01$322.82$272.02RVU26C
2026-04-01$322.82$272.02RVU26B
2026-01-01$322.82$272.02RVU26A
2025-10-01$293.41$273.05RVU25D
2025-07-01$293.41$273.05RVU25C
2025-04-01$293.41$273.05RVU25B
2025-01-01$293.41$273.05RVU25A
2024-10-01$298.03$277.07RVU24D
2024-07-01$298.03$277.07RVU24C
2024-04-01$298.03$277.07RVU24B
2024-03-09$298.03$277.07RVU24AR
2024-01-01$293.16$272.55RVU24A
2023-10-01$300.40$279.36RVU23D
2023-07-01$300.40$279.36RVU23C
2023-04-01$300.40$279.36RVU23B
2023-01-01$300.40$279.36RVU23A
2022-10-01$300.85$279.98RVU22D
2022-07-01$300.85$279.98RVU22C
2022-04-01$300.85$279.98RVU22B
2022-01-01$300.85$279.98RVU22A
2021-10-01$300.15$278.78RVU21D
2021-07-01$300.15$278.78RVU21C
2021-04-01$300.15$278.78RVU21B
2021-01-01$300.15$278.78RVU21A
2020-10-01$298.51$277.03RVU20D
2020-07-01$298.51$277.03RVU20C
2020-04-01$298.51$277.03RVU20B
2020-01-01$298.51$277.03RVU20A
2019-10-01$294.77$272.96RVU19D
2019-07-01$294.77$272.96RVU19C
2019-04-01$294.77$272.96RVU19B
2019-01-01$294.77$272.96RVU19A
2018-10-01$297.04$272.24RVU18D
2018-07-01$297.04$272.24RVU18C
2018-04-01$297.04$272.24RVU18B
2018-01-01$297.04$272.24RVU18AR1
2017-10-01$293.74$270.68RVU17D
2017-07-01$293.74$270.68RVU17C
2017-04-01$293.74$270.68RVU17B
2017-01-01$293.74$270.68RVU17A
2016-10-01$293.21$270.24RVU16D
2016-07-01$293.21$270.24RVU16C
2016-04-01$293.21$270.24RVU16B
2016-01-01$293.21$270.24RVU16A
2015-10-01$294.61$270.88RVU15D
2015-07-01$294.61$270.88RVU15C
2015-04-01$293.14$269.53RVU15B
2015-01-01$293.14$269.53RVU15A
2014-10-01$290.76$267.80RVU14D
2014-07-01$290.76$267.80RVU14C
2014-04-01$290.76$267.80RVU14B
2014-01-01$290.76$267.80RVU14A
2013-10-01$292.64$268.35RVU13D
2013-07-01$292.64$268.35RVU13C
2013-04-01$292.64$268.35RVU13B
2013-01-01$292.64$268.35RVU13AR

Price 25630 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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