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CPT code 25650: Fracture treatment, ulnar styloid, no manipulation2026 Medicare rate & RVUs in North Carolina

Closed treatment of an ulnar styloid fracture without manipulation, reported when the fracture is managed nonoperatively with immobilization and fracture-care follow-up.

CMS RVU26DEffective Oct 1, 2026One payment locality1.1K Medicare services in 2024

In North Carolina, Medicare pays $354.27 for 25650 in the office and $303.78 when it’s performed in a hospital or facility.

$354.27Office (non-facility)
$303.78Hospital or facility
−6.5%vs the national office rate ($379.10)

Check a contract rate as a % of Medicare · 25650 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 25650 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 25650 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 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.

How North Carolina compares for 25650

Across 109 of 109 payment localities, the office rate for 25650 runs from $332.90 in Arkansas to $491.76 in San Benito County, CA. North Carolina pays $354.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

25650 in North Carolina vs other payment areas
  1. North Carolina · this page$354.27
  2. Los Angeles, CA · California$422.09+$67.82
  3. Washington, DC area · District of Columbia$432.10+$77.83
  4. Miami, FL · Florida$423.13+$68.86
  5. Chicago, IL · Illinois$409.64+$55.37
  6. Manhattan, NY · New York$439.55+$85.28
  7. Alaska · Alaska$438.18+$83.91

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

Every other payment area

25650 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$338.05$290.71
ArkansasArkansas$332.90$286.42
ArizonaArizona$368.12$315.69
Bakersfield, CACalifornia$396.66$337.35
Chico, CACalifornia$394.84$335.53
El Centro, CACalifornia$394.95$335.64
Fresno, CACalifornia$394.84$335.53
Hanford, CACalifornia$394.84$335.53

25650 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.

$332.90

$443.30

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

View every state and territory as a table
25650 office rate range by state
State / territoryOffice rate rangeLocalities
AK$438.181
AL$338.051
AR$332.901
AZ$368.121
CA$394.84–$491.7629
CO$391.651
CT$405.231
DC$432.101
DE$374.381
FL$379.11–$423.133
GA$356.13–$387.882
GU$404.321
HI$404.321
IA$344.401
ID$347.341
IL$369.60–$409.644
IN$349.381
KS$343.991
KY$349.271
LA$349.21–$367.242
MA$389.66–$429.852
MD$381.37–$432.103
ME$350.62–$368.702
MI$360.03–$385.412
MN$370.881
MO$343.77–$367.063
MS$338.341
MT$379.061
NC$354.271
ND$366.011
NE$346.001
NH$386.671
NJ$408.62–$427.522
NM$362.631
NV$375.671
NY$359.96–$452.325
OH$357.371
OK$347.241
OR$371.55–$403.092
PA$357.24–$395.572
PR$381.541
RI$387.031
SC$356.651
SD$364.461
TN$345.981
TX$354.87–$391.408
UT$361.741
VA$368.34–$432.102
VI$381.541
VT$365.691
WA$388.55–$437.502
WI$353.271
WV$355.611
WY$373.371

See 25650 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,497

Code
25650
Physician work
3.15
Practice expense
7.54
Malpractice
0.66

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 25650 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.15× 1.0003.1500
Practice expense7.54× 0.9337.0348
Malpractice0.66× 0.6390.4217
Total RVUs10.6066
Conversion factor× 33.4009

Office rate, North Carolina$354.27

Office: (3.15 × 1 + 7.54 × 0.933 + 0.66 × 0.639) × $33.4009 = $354.27

Facility: (3.15 × 1 + 5.92 × 0.933 + 0.66 × 0.639) × $33.4009 = $303.78

Open 25650 in the RVU calculator

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

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)1Not paid (statutory restriction).
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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 25650

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

Codes related to 25650
CodeHow it relatesOffice range, North Carolina
Used instead
25651Fracture fixation, percutaneous ulnar styloidPercutaneous skeletal fixation for an ulnar styloid fracture.No office rate
25652Ulnar styloid fracture, open treatmentOpen treatment for an ulnar styloid fracture.No office rate
Often billed with
25600Fracture treatment, distal radius, no manipulationMay accompany treatment of a distinct distal radius fracture in the same encounter.$360.29

How 25650 has changed in North Carolina

25650 · Office / nonfacility

$354.27

Effective 2026-10-01

The base rate is $39.45 higher than on 2025-10-01, moving from $314.82 to $354.27 (12.5%).

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

    $314.82changed to$354.27

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.23 changed to 3.15
    • Practice expense RVU 6.57 changed to 7.54
    • Malpractice RVU 0.63 changed to 0.66
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $321.21changed to$314.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.48 changed to 6.57

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $315.96changed to$321.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $324.71changed to$315.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.34 changed to 6.48
    • Malpractice RVU 0.64 changed to 0.63
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $325.29changed to$324.71

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.11 changed to 6.34
    • Malpractice RVU 0.61 changed to 0.64
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $323.09changed to$325.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.95 changed to 6.11
    • Malpractice RVU 0.62 changed to 0.61

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $318.23changed to$323.09

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.52 changed to 5.95
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $312.29changed to$318.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.45 changed to 5.52
    • Malpractice RVU 0.52 changed to 0.60
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $310.52changed to$312.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.40 changed to 5.45
    • Malpractice RVU 0.53 changed to 0.52

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $307.19changed to$310.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.30 changed to 5.40
    • Malpractice RVU 0.54 changed to 0.53
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $307.92changed to$307.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.32 changed to 5.30
    • Malpractice RVU 0.55 changed to 0.54
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $308.42changed to$307.92

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.31 changed to 5.32
    • Malpractice RVU 0.54 changed to 0.55

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $306.88changed to$308.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $306.04changed to$306.88

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.27 changed to 5.31
    • Malpractice RVU 0.57 changed to 0.54
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $307.64changed to$306.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.82 changed to 5.27
    • Malpractice RVU 0.60 changed to 0.57
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $307.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$354.27$303.78RVU26D
2026-07-01$354.27$303.78RVU26C
2026-04-01$354.27$303.78RVU26B
2026-01-01$354.27$303.78RVU26A
2025-10-01$314.82$292.66RVU25D
2025-07-01$314.82$292.66RVU25C
2025-04-01$314.82$292.66RVU25B
2025-01-01$314.82$292.66RVU25A
2024-10-01$321.21$297.78RVU24D
2024-07-01$321.21$297.78RVU24C
2024-04-01$321.21$297.78RVU24B
2024-03-09$321.21$297.78RVU24AR
2024-01-01$315.96$292.92RVU24A
2023-10-01$324.71$301.15RVU23D
2023-07-01$324.71$301.15RVU23C
2023-04-01$324.71$301.15RVU23B
2023-01-01$324.71$301.15RVU23A
2022-10-01$325.29$301.20RVU22D
2022-07-01$325.29$301.20RVU22C
2022-04-01$325.29$301.20RVU22B
2022-01-01$325.29$301.20RVU22A
2021-10-01$323.09$299.45RVU21D
2021-07-01$323.09$299.45RVU21C
2021-04-01$323.09$299.45RVU21B
2021-01-01$323.09$299.45RVU21A
2020-10-01$318.23$296.41RVU20D
2020-07-01$318.23$296.41RVU20C
2020-04-01$318.23$296.41RVU20B
2020-01-01$318.23$296.41RVU20A
2019-10-01$312.29$291.15RVU19D
2019-07-01$312.29$291.15RVU19C
2019-04-01$312.29$291.15RVU19B
2019-01-01$312.29$291.15RVU19A
2018-10-01$310.52$290.41RVU18D
2018-07-01$310.52$290.41RVU18C
2018-04-01$310.52$290.41RVU18B
2018-01-01$310.52$290.41RVU18AR1
2017-10-01$307.19$288.82RVU17D
2017-07-01$307.19$288.82RVU17C
2017-04-01$307.19$288.82RVU17B
2017-01-01$307.19$288.82RVU17A
2016-10-01$307.92$289.27RVU16D
2016-07-01$307.92$289.27RVU16C
2016-04-01$307.92$289.27RVU16B
2016-01-01$307.92$289.27RVU16A
2015-10-01$308.42$289.70RVU15D
2015-07-01$308.42$289.70RVU15C
2015-04-01$306.88$288.26RVU15B
2015-01-01$306.88$288.26RVU15A
2014-10-01$306.04$288.07RVU14D
2014-07-01$306.04$288.07RVU14C
2014-04-01$306.04$288.07RVU14B
2014-01-01$306.04$288.07RVU14A
2013-10-01$307.64$288.09RVU13D
2013-07-01$307.64$288.09RVU13C
2013-04-01$307.64$288.09RVU13B
2013-01-01$307.64$288.09RVU13AR

Price 25650 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 25650PPRRVU2026_Oct_nonQPP.csv, line 2,497 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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