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CPT code 25635: Carpal fracture treatment, with manipulation, each bone2026 Medicare rate & RVUs in Los Angeles, CA

Reports closed manipulation to realign a fractured carpal bone other than the scaphoid, with separate reporting for each bone treated.

CMS RVU26DEffective Oct 1, 2026One payment locality90 Medicare services in 2024

In Los Angeles, CA, Medicare pays $578.07 for 25635 in the office and $462.70 when it’s performed in a hospital or facility.

$578.07Office (non-facility)
$462.70Hospital or facility
+11.0%vs the national office rate ($520.72)

Check a contract rate as a % of Medicare · 25635 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 25635 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 25635 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 25635 covers

An orthopedist, hand surgeon, or other qualified treating clinician reports this service when a carpal fracture other than a scaphoid fracture is treated without surgical exposure and requires manipulation to restore alignment. Examples of eligible bones include the triquetrum, lunate, capitate, hamate, trapezium, trapezoid, and pisiform. Treatment may occur in an emergency department, clinic, or other setting where the clinician provides fracture care.

Select the code for each bone treated and document the fracture site, laterality, closed approach, and the manipulation performed. A fracture treated without manipulation is reported with 25630; scaphoid fractures belong to their own code family. The 90-day global includes the day-before preoperative visit and 90 days of 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 payment requires documented medical necessity; 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 Los Angeles, CA compares for 25635

Across 109 of 109 payment localities, the office rate for 25635 runs from $457.41 in Arkansas to $672.04 in San Benito County, CA. Los Angeles, CA pays $578.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

25635 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$578.07
  2. Bakersfield, CA · California$543.55−$34.52
  3. Chico, CA · California$540.91−$37.16
  4. El Centro, CA · California$541.07−$37.00
  5. Fresno, CA · California$540.91−$37.16
  6. Hanford, CA · California$540.91−$37.16
  7. Madera, CA · California$540.91−$37.16

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

Every other payment area

25635 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$540.91$434.01
Modesto, CACalifornia$540.91$434.01
Napa, CACalifornia$622.09$493.55
Oxnard, CACalifornia$574.47$459.19
Redding, CACalifornia$540.91$434.01
Rest of CaliforniaCalifornia$540.91$434.01
Riverside, CACalifornia$551.22$444.33
Sacramento, CACalifornia$566.45$453.02

25635 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.

$457.41

$606.47

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

View every state and territory as a table
25635 office rate range by state
State / territoryOffice rate rangeLocalities
AK$603.321
AL$464.471
AR$457.411
AZ$505.601
CA$540.91–$672.0429
CO$537.171
CT$556.531
DC$592.731
DE$514.171
FL$521.95–$583.633
GA$490.30–$533.032
GU$553.621
HI$553.621
IA$472.601
ID$476.731
IL$509.31–$564.994
IN$479.511
KS$472.301
KY$480.401
LA$480.42–$505.102
MA$534.56–$589.052
MD$523.65–$592.733
ME$481.50–$505.842
MI$495.39–$530.862
MN$507.971
MO$473.15–$504.533
MS$465.271
MT$520.661
NC$486.451
ND$501.671
NE$474.701
NH$530.601
NJ$560.99–$586.542
NM$499.051
NV$515.701
NY$494.26–$621.815
OH$491.511
OK$477.331
OR$509.84–$552.502
PA$491.18–$543.492
PR$523.961
RI$531.281
SC$490.171
SD$499.431
TN$475.051
TX$487.96–$537.018
UT$497.131
VA$505.54–$592.732
VI$523.961
VT$501.491
WA$532.96–$599.232
WI$484.311
WV$490.171
WY$512.381

See 25635 in every payment locality

How the 25635 rate is calculated

Each of 25635’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 · 25635

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.49

4.49 RVUs× 1.000 GPCI

Practice expense10.14

10.14 RVUs× 1.000 GPCI

Malpractice0.96

0.96 RVUs× 1.000 GPCI

Adjusted RVUs

15.5900

Conversion factor

$33.4009

Medicare rate

$520.72

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,495

Code
25635
Physician work
4.49
Practice expense
10.14
Malpractice
0.96

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 25635 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0414.6741
Practice expense10.14× 1.18311.9956
Malpractice0.96× 0.6640.6374
Total RVUs17.3072
Conversion factor× 33.4009

Office rate, Los Angeles, CA$578.07

Office: (4.49 × 1.041 + 10.14 × 1.183 + 0.96 × 0.664) × $33.4009 = $578.07

Facility: (4.49 × 1.041 + 7.22 × 1.183 + 0.96 × 0.664) × $33.4009 = $462.70

Open 25635 in the RVU calculator

Payment rules and modifiers for 25635

25635 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25635

Carpal fracture treatment, with 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)0Not paid without supporting documentation.
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 · 25635

Carpal fracture treatment, with 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

25635 without 50 · national office

$520.72

Carpal fracture treatment, with manipulation, each bone

25635-50 · Bilateral: 150%

$781.08

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 25635

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

Codes related to 25635
CodeHow it relatesOffice range, Los Angeles, CA
Same family
25630Carpal fracture care, without manipulation, each boneClosed treatment of another carpal bone fracture without manipulation.$384.13
Used instead
25645Carpal fracture repair, other than scaphoid, each boneOpen treatment for a carpal fracture other than the scaphoid.No office rate
25622Scaphoid fracture care, without manipulationClosed treatment without manipulation when the fractured carpal bone is the scaphoid.$392.63
25624Scaphoid fracture care, with manipulationClosed treatment with manipulation when the fractured carpal bone is the scaphoid.$610.21
25628Scaphoid fixation, open treatment with fixationOpen treatment with internal fixation for a scaphoid fracture.No office rate

How 25635 has changed in Los Angeles, CA

25635 · Office / nonfacility

$578.07

Effective 2026-10-01

The base rate is $49.09 higher than on 2025-10-01, moving from $528.98 to $578.07 (9.3%).

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

    $528.98changed to$578.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.61 changed to 4.49
    • Practice expense RVU 9.13 changed to 10.14
    • Malpractice RVU 0.94 changed to 0.96
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $538.47changed to$528.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.97 changed to 9.13
    • Malpractice RVU 0.96 changed to 0.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $529.68changed to$538.47

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $537.35changed to$529.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.76 changed to 8.97
    • Malpractice RVU 0.91 changed to 0.96
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $536.08changed to$537.35

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.46 changed to 8.76
    • Malpractice RVU 0.95 changed to 0.91
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $533.44changed to$536.08

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.30 changed to 8.46
    • Malpractice RVU 0.93 changed to 0.95

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $524.96changed to$533.44

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.71 changed to 8.30
    • Malpractice RVU 0.90 changed to 0.93
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $519.67changed to$524.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.60 changed to 7.71
    • Malpractice RVU 0.94 changed to 0.90
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $518.92changed to$519.67

    • Malpractice RVU 0.91 changed to 0.94

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $516.56changed to$518.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.54 changed to 7.60
    • Malpractice RVU 0.94 changed to 0.91

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $472.34changed to$516.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.65 changed to 7.54
    • Malpractice RVU 0.70 changed to 0.94
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $478.71changed to$472.34

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.78 changed to 6.65
    • Malpractice RVU 0.74 changed to 0.70
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $503.79changed to$478.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.16 changed to 6.78
    • Malpractice RVU 0.97 changed to 0.74

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $501.29changed to$503.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $490.07changed to$501.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.09 changed to 7.16
    • Malpractice RVU 0.86 changed to 0.97
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $500.57changed to$490.07

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.11 changed to 7.09
    • Malpractice RVU 0.90 changed to 0.86
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  17. October 1, 2013

    RVU13D

    No ratechanged to$500.57

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$578.07$462.70RVU26D
2026-07-01$578.07$462.70RVU26C
2026-04-01$578.07$462.70RVU26B
2026-01-01$578.07$462.70RVU26A
2025-10-01$528.98$476.45RVU25D
2025-07-01$528.98$476.45RVU25C
2025-04-01$528.98$476.45RVU25B
2025-01-01$528.98$476.45RVU25A
2024-10-01$538.47$484.41RVU24D
2024-07-01$538.47$484.41RVU24C
2024-04-01$538.47$484.41RVU24B
2024-03-09$538.47$484.41RVU24AR
2024-01-01$529.68$476.51RVU24A
2023-10-01$537.35$483.94RVU23D
2023-07-01$537.35$483.94RVU23C
2023-04-01$537.35$483.94RVU23B
2023-01-01$537.35$483.94RVU23A
2022-10-01$536.08$483.22RVU22D
2022-07-01$536.08$483.22RVU22C
2022-04-01$536.08$483.22RVU22B
2022-01-01$536.08$483.22RVU22A
2021-10-01$533.44$480.55RVU21D
2021-07-01$533.44$480.55RVU21C
2021-04-01$533.44$480.55RVU21B
2021-01-01$533.44$480.55RVU21A
2020-10-01$524.96$474.46RVU20D
2020-07-01$524.96$474.46RVU20C
2020-04-01$524.96$474.46RVU20B
2020-01-01$524.96$474.46RVU20A
2019-10-01$519.67$469.62RVU19D
2019-07-01$519.67$469.62RVU19C
2019-04-01$518.92$468.87RVU19B
2019-01-01$518.92$468.87RVU19A
2018-10-01$516.56$466.98RVU18D
2018-07-01$516.56$466.98RVU18C
2018-04-01$516.56$466.98RVU18B
2018-01-01$516.56$466.98RVU18AR1
2017-10-01$472.34$420.74RVU17D
2017-07-01$472.34$420.74RVU17C
2017-04-01$472.34$420.74RVU17B
2017-01-01$472.34$420.74RVU17A
2016-10-01$478.71$425.50RVU16D
2016-07-01$478.71$425.50RVU16C
2016-04-01$478.71$425.50RVU16B
2016-01-01$478.71$425.50RVU16A
2015-10-01$503.79$445.81RVU15D
2015-07-01$503.79$445.81RVU15C
2015-04-01$501.29$443.59RVU15B
2015-01-01$501.29$443.59RVU15A
2014-10-01$490.07$433.24RVU14D
2014-07-01$490.07$433.24RVU14C
2014-04-01$490.07$433.24RVU14B
2014-01-01$490.07$433.24RVU14A
2013-10-01$500.57$438.93RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 25635 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

25635 billing questions

How does this differ from 25630?

Use 25635 when closed treatment includes manipulation to realign the fracture. Code 25630 is for closed treatment without manipulation.

Can this code be used for a scaphoid fracture?

No. Scaphoid fractures are reported from the scaphoid-specific family, such as 25622 or 25624, depending on whether manipulation is performed.

How many units should be reported?

The code is reported for each carpal bone treated. Document the bone and the manipulation for each treated fracture.

What does the 90-day global include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral treatment reported?

When the service is performed bilaterally, modifier 50 applies; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is available only with documentation of medical necessity. 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 25635PPRRVU2026_Oct_nonQPP.csv, line 2,495 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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