FeeBase
Log inGet started
Menu

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

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 Utah, Medicare pays $497.13 for 25635 in the office and $405.45 when it’s performed in a hospital or facility.

$497.13Office (non-facility)
$405.45Hospital or facility
−4.5%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 Utah
  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 Utah 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. Utah pays $497.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

25635 in Utah vs other payment areas
  1. Utah · this page$497.13
  2. Los Angeles, CA · California$578.07+$80.94
  3. Washington, DC area · District of Columbia$592.73+$95.60
  4. Miami, FL · Florida$583.63+$86.50
  5. Chicago, IL · Illinois$564.99+$67.86
  6. Manhattan, NY · New York$603.98+$106.85
  7. Alaska · Alaska$603.32+$106.19

Other areas in Utah 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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 25635 in Utah
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0004.4900
Practice expense10.14× 0.9409.5316
Malpractice0.96× 0.8980.8621
Total RVUs14.8837
Conversion factor× 33.4009

Office rate, Utah$497.13

Office: (4.49 × 1 + 10.14 × 0.94 + 0.96 × 0.898) × $33.4009 = $497.13

Facility: (4.49 × 1 + 7.22 × 0.94 + 0.96 × 0.898) × $33.4009 = $405.45

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, Utah
Same family
25630Carpal fracture care, without manipulation, each boneClosed treatment of another carpal bone fracture without manipulation.$329.43
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.$334.36
25624Scaphoid fracture care, with manipulationClosed treatment with manipulation when the fractured carpal bone is the scaphoid.$524.08
25628Scaphoid fixation, open treatment with fixationOpen treatment with internal fixation for a scaphoid fracture.No office rate

How 25635 has changed in Utah

25635 · Office / nonfacility

$497.13

Effective 2026-10-01

The base rate is $44.20 higher than on 2025-10-01, moving from $452.93 to $497.13 (9.8%).

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

    $452.93changed to$497.13

    • 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
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $461.76changed to$452.93

    • 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

    $454.22changed to$461.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $457.78changed to$454.22

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $454.86changed to$457.78

    • 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
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $452.94changed to$454.86

    • 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

    $455.09changed to$452.94

    • 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
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $459.51changed to$455.09

    • 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
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $458.25changed to$459.51

    • Malpractice RVU 0.91 changed to 0.94

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $457.00changed to$458.25

    • 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

    $415.52changed to$457.00

    • 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
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $419.85changed to$415.52

    • 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 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $443.62changed to$419.85

    • 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

    $441.41changed to$443.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $433.55changed to$441.41

    • 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 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $443.34changed to$433.55

    • 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 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $443.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$497.13$405.45RVU26D
2026-07-01$497.13$405.45RVU26C
2026-04-01$497.13$405.45RVU26B
2026-01-01$497.13$405.45RVU26A
2025-10-01$452.93$411.89RVU25D
2025-07-01$452.93$411.89RVU25C
2025-04-01$452.93$411.89RVU25B
2025-01-01$452.93$411.89RVU25A
2024-10-01$461.76$419.52RVU24D
2024-07-01$461.76$419.52RVU24C
2024-04-01$461.76$419.52RVU24B
2024-03-09$461.76$419.52RVU24AR
2024-01-01$454.22$412.67RVU24A
2023-10-01$457.78$416.04RVU23D
2023-07-01$457.78$416.04RVU23C
2023-04-01$457.78$416.04RVU23B
2023-01-01$457.78$416.04RVU23A
2022-10-01$454.86$413.51RVU22D
2022-07-01$454.86$413.51RVU22C
2022-04-01$454.86$413.51RVU22B
2022-01-01$454.86$413.51RVU22A
2021-10-01$452.94$411.57RVU21D
2021-07-01$452.94$411.57RVU21C
2021-04-01$452.94$411.57RVU21B
2021-01-01$452.94$411.57RVU21A
2020-10-01$455.09$415.45RVU20D
2020-07-01$455.09$415.45RVU20C
2020-04-01$455.09$415.45RVU20B
2020-01-01$455.09$415.45RVU20A
2019-10-01$459.51$420.09RVU19D
2019-07-01$459.51$420.09RVU19C
2019-04-01$458.25$418.83RVU19B
2019-01-01$458.25$418.83RVU19A
2018-10-01$457.00$417.96RVU18D
2018-07-01$457.00$417.96RVU18C
2018-04-01$457.00$417.96RVU18B
2018-01-01$457.00$417.96RVU18AR1
2017-10-01$415.52$374.69RVU17D
2017-07-01$415.52$374.69RVU17C
2017-04-01$415.52$374.69RVU17B
2017-01-01$415.52$374.69RVU17A
2016-10-01$419.85$377.59RVU16D
2016-07-01$419.85$377.59RVU16C
2016-04-01$419.85$377.59RVU16B
2016-01-01$419.85$377.59RVU16A
2015-10-01$443.62$397.56RVU15D
2015-07-01$443.62$397.56RVU15C
2015-04-01$441.41$395.59RVU15B
2015-01-01$441.41$395.59RVU15A
2014-10-01$433.55$388.45RVU14D
2014-07-01$433.55$388.45RVU14C
2014-04-01$433.55$388.45RVU14B
2014-01-01$433.55$388.45RVU14A
2013-10-01$443.34$394.41RVU13D
2013-07-01$443.34$394.41RVU13C
2013-04-01$443.34$394.41RVU13B
2013-01-01$443.34$394.41RVU13AR

Price 25635 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 25635 pays in Utah?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 25635 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist