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

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 Washington, DC area, Medicare pays $592.73 for 25635 in the office and $477.84 when it’s performed in a hospital or facility.

$592.73Office (non-facility)
$477.84Hospital or facility
+13.8%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $592.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

25635 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$592.73
  2. Los Angeles, CA · California$578.07−$14.66
  3. Miami, FL · Florida$583.63−$9.10
  4. Chicago, IL · Illinois$564.99−$27.74
  5. Manhattan, NY · New York$603.98+$11.25
  6. Alaska · Alaska$603.32+$10.59
  7. Alabama · Alabama$464.47−$128.26

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

25635 in every other Medicare payment locality
Payment localityOfficeFacility
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
Madera, 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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 25635 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0544.7325
Practice expense10.14× 1.17811.9449
Malpractice0.96× 1.1131.0685
Total RVUs17.7459
Conversion factor× 33.4009

Office rate, Washington, DC area$592.73

Office: (4.49 × 1.054 + 10.14 × 1.178 + 0.96 × 1.113) × $33.4009 = $592.73

Facility: (4.49 × 1.054 + 7.22 × 1.178 + 0.96 × 1.113) × $33.4009 = $477.84

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, Washington, DC area
Same family
25630Carpal fracture care, without manipulation, each boneClosed treatment of another carpal bone fracture without manipulation.$392.97
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.$400.70
25624Scaphoid fracture care, with manipulationClosed treatment with manipulation when the fractured carpal bone is the scaphoid.$625.42
25628Scaphoid fixation, open treatment with fixationOpen treatment with internal fixation for a scaphoid fracture.No office rate

How 25635 has changed in Washington, DC area

25635 · Office / nonfacility

$592.73

Effective 2026-10-01

The base rate is $47.57 higher than on 2025-10-01, moving from $545.16 to $592.73 (8.7%).

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

    $545.16changed to$592.73

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $555.44changed to$545.16

    • 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

    $546.38changed to$555.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $563.31changed to$546.38

    • 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 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $572.55changed to$563.31

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $569.50changed to$572.55

    • 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

    $555.75changed to$569.50

    • 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 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $546.38changed to$555.75

    • 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 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $545.02changed to$546.38

    • Malpractice RVU 0.91 changed to 0.94

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $543.18changed to$545.02

    • 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

    $492.90changed to$543.18

    • 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 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $499.91changed to$492.90

    • 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 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $528.74changed to$499.91

    • 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

    $526.11changed to$528.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $515.81changed to$526.11

    • 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 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $529.69changed to$515.81

    • 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 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $529.69

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$592.73$477.84RVU26D
2026-07-01$592.73$477.84RVU26C
2026-04-01$592.73$477.84RVU26B
2026-01-01$592.73$477.84RVU26A
2025-10-01$545.16$492.72RVU25D
2025-07-01$545.16$492.72RVU25C
2025-04-01$545.16$492.72RVU25B
2025-01-01$545.16$492.72RVU25A
2024-10-01$555.44$501.48RVU24D
2024-07-01$555.44$501.48RVU24C
2024-04-01$555.44$501.48RVU24B
2024-03-09$555.44$501.48RVU24AR
2024-01-01$546.38$493.30RVU24A
2023-10-01$563.31$508.59RVU23D
2023-07-01$563.31$508.59RVU23C
2023-04-01$563.31$508.59RVU23B
2023-01-01$563.31$508.59RVU23A
2022-10-01$572.55$516.95RVU22D
2022-07-01$572.55$516.95RVU22C
2022-04-01$572.55$516.95RVU22B
2022-01-01$572.55$516.95RVU22A
2021-10-01$569.50$513.86RVU21D
2021-07-01$569.50$513.86RVU21C
2021-04-01$569.50$513.86RVU21B
2021-01-01$569.50$513.86RVU21A
2020-10-01$555.75$503.31RVU20D
2020-07-01$555.75$503.31RVU20C
2020-04-01$555.75$503.31RVU20B
2020-01-01$555.75$503.31RVU20A
2019-10-01$546.38$495.14RVU19D
2019-07-01$546.38$495.14RVU19C
2019-04-01$545.02$493.77RVU19B
2019-01-01$545.02$493.77RVU19A
2018-10-01$543.18$492.43RVU18D
2018-07-01$543.18$492.43RVU18C
2018-04-01$543.18$492.43RVU18B
2018-01-01$543.18$492.43RVU18AR1
2017-10-01$492.90$439.71RVU17D
2017-07-01$492.90$439.71RVU17C
2017-04-01$492.90$439.71RVU17B
2017-01-01$492.90$439.71RVU17A
2016-10-01$499.91$444.68RVU16D
2016-07-01$499.91$444.68RVU16C
2016-04-01$499.91$444.68RVU16B
2016-01-01$499.91$444.68RVU16A
2015-10-01$528.74$468.56RVU15D
2015-07-01$528.74$468.56RVU15C
2015-04-01$526.11$466.23RVU15B
2015-01-01$526.11$466.23RVU15A
2014-10-01$515.81$456.82RVU14D
2014-07-01$515.81$456.82RVU14C
2014-04-01$515.81$456.82RVU14B
2014-01-01$515.81$456.82RVU14A
2013-10-01$529.69$465.70RVU13D
2013-07-01$529.69$465.70RVU13C
2013-04-01$529.69$465.70RVU13B
2013-01-01$529.69$465.70RVU13AR

Price 25635 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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