CPT code 25650: Fracture treatment, ulnar styloid, no manipulation2026 Medicare rate & RVUs in California
Closed treatment of an ulnar styloid fracture without manipulation, reported when the fracture is managed nonoperatively with immobilization and fracture-care follow-up.
Medicare pays $394.84–$491.76 for 25650 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 25650 covers
This code covers nonoperative care of an ulnar styloid fracture when the provider treats the fracture without manipulating or reducing it. An orthopedic or hand surgeon may provide definitive fracture care in an office or facility; emergency clinicians may stabilize the wrist, but this code represents the provider’s fracture-treatment service. Routine immobilization and fracture-care follow-up are part of the treatment episode.
Report the code when documentation identifies the ulnar styloid fracture and supports treatment without manipulation. Record the affected side, treatment plan, and follow-up responsibility; distinguish the styloid injury from any separately treated distal radius fracture. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. With modifier 50, bilateral treatment is paid at 150%. Assistant-at-surgery payment is statutorily 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.
Where 25650 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$394.84 to $491.76
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $396.66 | $337.35 |
| Chico, CA | $394.84 | $335.53 |
| El Centro, CA | $394.95 | $335.64 |
| Fresno, CA | $394.84 | $335.53 |
| Hanford, CA | $394.84 | $335.53 |
| Los Angeles, CA | $422.09 | $358.08 |
| Madera, CA | $394.84 | $335.53 |
| Marin County, CA | $480.42 | $404.13 |
| Merced, CA | $394.84 | $335.53 |
| Modesto, CA | $394.84 | $335.53 |
| Napa, CA | $454.97 | $383.65 |
| Oxnard, CA | $419.57 | $355.61 |
| Redding, CA | $394.84 | $335.53 |
| Rest of California | $394.84 | $335.53 |
| Riverside, CA | $401.93 | $342.63 |
| Sacramento, CA | $413.71 | $350.78 |
| Salinas, CA | $412.18 | $349.46 |
| San Benito County, CA | $491.76 | $413.73 |
| San Diego, CA | $421.52 | $356.81 |
| San Francisco, CA | $479.68 | $403.38 |
| San Luis Obispo, CA | $405.67 | $344.04 |
| Santa Clara County, CA | $488.70 | $410.67 |
| Santa Cruz, CA | $425.23 | $359.48 |
| Santa Maria, CA | $413.62 | $350.53 |
| Santa Rosa, CA | $429.45 | $363.00 |
| Stockton, CA | $394.84 | $335.53 |
| Vallejo, CA | $453.89 | $382.57 |
| Visalia, CA | $394.84 | $335.53 |
| Yuba City, CA | $394.84 | $335.53 |
How the 25650 rate is calculated
Each of 25650’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 · 25650
RVUs × geographic indexes × conversion factor
Work3.15
3.15 RVUs× 1.000 GPCI
Practice expense7.54
7.54 RVUs× 1.000 GPCI
Malpractice0.66
0.66 RVUs× 1.000 GPCI
Adjusted RVUs
11.3500
Conversion factor
$33.4009
Medicare rate
$379.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25650
25650 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25650
Fracture treatment, ulnar styloid, no manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25650
Fracture treatment, ulnar styloid, no manipulation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25650 without 50 · national office
$379.10
Fracture treatment, ulnar styloid, no manipulation
25650-50 · Bilateral: 150%
$568.65
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).
25650 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25651Fracture fixationPercutaneous ulnar styloid
- Choose 25651 when the ulnar styloid fracture is treated with percutaneous skeletal fixation; 25650 describes closed treatment without manipulation.
- 25652Ulnar styloid fractureOpen treatment
- Choose 25652 for open treatment of the ulnar styloid fracture. This code is for closed treatment without manipulation.
- 25600Fracture treatmentDistal radius, no manipulation
- 25600 treats a distal radius fracture without manipulation, not an ulnar styloid fracture. A separate, treated fracture of each bone may support reporting both codes.
25650 billing questions
When is this code appropriate instead of a manipulation code?
Use it when the ulnar styloid fracture is treated without manipulation. If the provider manipulates the fracture, this code does not describe the service.
Can this be reported with a distal radius fracture code?
It may be reported with a code for a separately treated distal radius fracture when both injuries receive distinct treatment. Document each fracture and its treatment.
Is routine casting or fracture follow-up separately reported?
Routine immobilization and related fracture-care follow-up are part of the fracture-treatment episode. Related postoperative care is included in the 90-day global period.
What modifier applies when both wrists are treated?
CMS identifies this as a bilateral procedure; report modifier 50 when appropriate. Bilateral payment is 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is statutorily 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
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