CPT code 25630: Carpal fracture care, without manipulation, each bone2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $397.97 for 25630 in the office and $331.17 when it’s performed in a hospital or facility.

$397.97Office (non-facility)
$331.17Hospital or facility
+15.3%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 King County, WA
  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 King County, WA 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. King County, WA pays $397.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

25630 in King County, WA vs other payment areas
  1. King County, WA · this page$397.97
  2. Rest of Washington · Washington$353.72−$44.25
  3. Los Angeles, CA · California$384.13−$13.84
  4. Washington, DC area · District of Columbia$392.97−$5.00
  5. Miami, FL · Florida$383.96−$14.01
  6. Chicago, IL · Illinois$371.94−$26.03
  7. Manhattan, NY · New York$399.48+$1.51

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

Every other payment area

25630 in every other Medicare payment locality
Payment localityOfficeFacility
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
Fresno, 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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 25630 in King County, WA
ComponentRVULocality factorAdjusted
Physician work2.95× 1.0503.0975
Practice expense6.80× 1.2278.3436
Malpractice0.58× 0.8170.4739
Total RVUs11.9150
Conversion factor× 33.4009

Office rate, King County, WA$397.97

Office: (2.95 × 1.05 + 6.8 × 1.227 + 0.58 × 0.817) × $33.4009 = $397.97

Facility: (2.95 × 1.05 + 5.17 × 1.227 + 0.58 × 0.817) × $33.4009 = $331.17

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 King County, WA

25630 · Office / nonfacility

$397.97

Effective 2026-10-01

The base rate is $38.74 higher than on 2025-10-01, moving from $359.23 to $397.97 (10.8%).

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

    $359.23changed to$397.97

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $364.52changed to$359.23

    • 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

    $358.57changed to$364.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $361.16changed to$358.57

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.83 changed to 5.98
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853
  5. January 1, 2023

    RVU23A

    $355.33changed to$361.16

    • 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 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $354.25changed to$355.33

    • 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

    $348.73changed to$354.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.18 changed to 5.51
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $341.96changed to$348.73

    • 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 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $344.81changed to$341.96

    • 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

    $336.63changed to$344.81

    • 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 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $331.91changed to$336.63

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.11 changed to 5.12
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $333.52changed to$331.91

    • 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

    $331.86changed to$333.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $332.61changed to$331.86

    • 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 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $340.03changed to$332.61

    • 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 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $340.03

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$397.97$331.17RVU26D
2026-07-01$397.97$331.17RVU26C
2026-04-01$397.97$331.17RVU26B
2026-01-01$397.97$331.17RVU26A
2025-10-01$359.23$332.39RVU25D
2025-07-01$359.23$332.39RVU25C
2025-04-01$359.23$332.39RVU25B
2025-01-01$359.23$332.39RVU25A
2024-10-01$364.52$336.90RVU24D
2024-07-01$364.52$336.90RVU24C
2024-04-01$364.52$336.90RVU24B
2024-03-09$364.52$336.90RVU24AR
2024-01-01$358.57$331.41RVU24A
2023-10-01$361.16$333.75RVU23D
2023-07-01$361.16$333.75RVU23C
2023-04-01$361.16$333.75RVU23B
2023-01-01$361.16$333.75RVU23A
2022-10-01$355.33$328.47RVU22D
2022-07-01$355.33$328.47RVU22C
2022-04-01$355.33$328.47RVU22B
2022-01-01$355.33$328.47RVU22A
2021-10-01$354.25$326.76RVU21D
2021-07-01$354.25$326.76RVU21C
2021-04-01$354.25$326.76RVU21B
2021-01-01$354.25$326.76RVU21A
2020-10-01$348.73$321.70RVU20D
2020-07-01$348.73$321.70RVU20C
2020-04-01$348.73$321.70RVU20B
2020-01-01$348.73$321.70RVU20A
2019-10-01$341.96$315.11RVU19D
2019-07-01$341.96$315.11RVU19C
2019-04-01$341.96$315.11RVU19B
2019-01-01$341.96$315.11RVU19A
2018-10-01$344.81$314.28RVU18D
2018-07-01$344.81$314.28RVU18C
2018-04-01$344.81$314.28RVU18B
2018-01-01$344.81$314.28RVU18AR1
2017-10-01$336.63$308.13RVU17D
2017-07-01$336.63$308.13RVU17C
2017-04-01$336.63$308.13RVU17B
2017-01-01$336.63$308.13RVU17A
2016-10-01$331.91$303.38RVU16D
2016-07-01$331.91$303.38RVU16C
2016-04-01$331.91$303.38RVU16B
2016-01-01$331.91$303.38RVU16A
2015-10-01$333.52$304.06RVU15D
2015-07-01$333.52$304.06RVU15C
2015-04-01$331.86$302.54RVU15B
2015-01-01$331.86$302.54RVU15A
2014-10-01$332.61$304.18RVU14D
2014-07-01$332.61$304.18RVU14C
2014-04-01$332.61$304.18RVU14B
2014-01-01$332.61$304.18RVU14A
2013-10-01$340.03$310.06RVU13D
2013-07-01$340.03$310.06RVU13C
2013-04-01$340.03$310.06RVU13B
2013-01-01$340.03$310.06RVU13AR

Price 25630 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 25630 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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