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

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 Connecticut, Medicare pays $556.53 for 25635 in the office and $451.49 when it’s performed in a hospital or facility.

$556.53Office (non-facility)
$451.49Hospital or facility
+6.9%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 Connecticut
  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 Connecticut 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. Connecticut pays $556.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

25635 in Connecticut vs other payment areas
  1. Connecticut · this page$556.53
  2. Los Angeles, CA · California$578.07+$21.54
  3. Washington, DC area · District of Columbia$592.73+$36.20
  4. Miami, FL · Florida$583.63+$27.10
  5. Chicago, IL · Illinois$564.99+$8.46
  6. Manhattan, NY · New York$603.98+$47.45
  7. Alaska · Alaska$603.32+$46.79

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

Every other payment area

25635 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$464.47$379.13
ArkansasArkansas$457.41$373.64
ArizonaArizona$505.60$411.10
Bakersfield, CACalifornia$543.55$436.65
Chico, CACalifornia$540.91$434.01
El Centro, CACalifornia$541.07$434.17
Fresno, CACalifornia$540.91$434.01
Hanford, CACalifornia$540.91$434.01

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 Connecticut 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

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 25635 in Connecticut
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0204.5798
Practice expense10.14× 1.07710.9208
Malpractice0.96× 1.2101.1616
Total RVUs16.6622
Conversion factor× 33.4009

Office rate, Connecticut$556.53

Office: (4.49 × 1.02 + 10.14 × 1.077 + 0.96 × 1.21) × $33.4009 = $556.53

Facility: (4.49 × 1.02 + 7.22 × 1.077 + 0.96 × 1.21) × $33.4009 = $451.49

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, Connecticut
Same family
25630Carpal fracture care, without manipulation, each boneClosed treatment of another carpal bone fracture without manipulation.$368.56
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.$374.93
25624Scaphoid fracture care, with manipulationClosed treatment with manipulation when the fractured carpal bone is the scaphoid.$586.98
25628Scaphoid fixation, open treatment with fixationOpen treatment with internal fixation for a scaphoid fracture.No office rate

How 25635 has changed in Connecticut

25635 · Office / nonfacility

$556.53

Effective 2026-10-01

The base rate is $45.23 higher than on 2025-10-01, moving from $511.30 to $556.53 (8.8%).

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

    $511.30changed to$556.53

    • 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 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $521.16changed to$511.30

    • 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

    $512.66changed to$521.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $521.03changed to$512.66

    • 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 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $522.29changed to$521.03

    • 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 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $519.75changed to$522.29

    • 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

    $516.42changed to$519.75

    • 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 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $516.72changed to$516.42

    • 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 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $515.36changed to$516.72

    • Malpractice RVU 0.91 changed to 0.94

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $513.75changed to$515.36

    • 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

    $467.09changed to$513.75

    • 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 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $473.79changed to$467.09

    • 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
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $500.99changed to$473.79

    • 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

    $498.49changed to$500.99

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $490.57changed to$498.49

    • 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
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $504.71changed to$490.57

    • 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
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $504.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$556.53$451.49RVU26D
2026-07-01$556.53$451.49RVU26C
2026-04-01$556.53$451.49RVU26B
2026-01-01$556.53$451.49RVU26A
2025-10-01$511.30$463.30RVU25D
2025-07-01$511.30$463.30RVU25C
2025-04-01$511.30$463.30RVU25B
2025-01-01$511.30$463.30RVU25A
2024-10-01$521.16$471.77RVU24D
2024-07-01$521.16$471.77RVU24C
2024-04-01$521.16$471.77RVU24B
2024-03-09$521.16$471.77RVU24AR
2024-01-01$512.66$464.07RVU24A
2023-10-01$521.03$471.37RVU23D
2023-07-01$521.03$471.37RVU23C
2023-04-01$521.03$471.37RVU23B
2023-01-01$521.03$471.37RVU23A
2022-10-01$522.29$472.17RVU22D
2022-07-01$522.29$472.17RVU22C
2022-04-01$522.29$472.17RVU22B
2022-01-01$522.29$472.17RVU22A
2021-10-01$519.75$469.60RVU21D
2021-07-01$519.75$469.60RVU21C
2021-04-01$519.75$469.60RVU21B
2021-01-01$519.75$469.60RVU21A
2020-10-01$516.42$468.63RVU20D
2020-07-01$516.42$468.63RVU20C
2020-04-01$516.42$468.63RVU20B
2020-01-01$516.42$468.63RVU20A
2019-10-01$516.72$469.43RVU19D
2019-07-01$516.72$469.43RVU19C
2019-04-01$515.36$468.07RVU19B
2019-01-01$515.36$468.07RVU19A
2018-10-01$513.75$466.91RVU18D
2018-07-01$513.75$466.91RVU18C
2018-04-01$513.75$466.91RVU18B
2018-01-01$513.75$466.91RVU18AR1
2017-10-01$467.09$417.78RVU17D
2017-07-01$467.09$417.78RVU17C
2017-04-01$467.09$417.78RVU17B
2017-01-01$467.09$417.78RVU17A
2016-10-01$473.79$422.41RVU16D
2016-07-01$473.79$422.41RVU16C
2016-04-01$473.79$422.41RVU16B
2016-01-01$473.79$422.41RVU16A
2015-10-01$500.99$445.00RVU15D
2015-07-01$500.99$445.00RVU15C
2015-04-01$498.49$442.78RVU15B
2015-01-01$498.49$442.78RVU15A
2014-10-01$490.57$435.80RVU14D
2014-07-01$490.57$435.80RVU14C
2014-04-01$490.57$435.80RVU14B
2014-01-01$490.57$435.80RVU14A
2013-10-01$504.71$445.41RVU13D
2013-07-01$504.71$445.41RVU13C
2013-04-01$504.71$445.41RVU13B
2013-01-01$504.71$445.41RVU13AR

Price 25635 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

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 ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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