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

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 Virginia, Medicare pays $368.34 for 25650 in the office and $315.15 when it’s performed in a hospital or facility.

$368.34Office (non-facility)
$315.15Hospital or facility
−2.8%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 Virginia
  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 Virginia 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. Virginia pays $368.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

25650 in Virginia vs other payment areas
  1. Virginia · this page$368.34
  2. Los Angeles, CA · California$422.09+$53.75
  3. Washington, DC area · District of Columbia$432.10+$63.76
  4. Miami, FL · Florida$423.13+$54.79
  5. Chicago, IL · Illinois$409.64+$41.30
  6. Manhattan, NY · New York$439.55+$71.21
  7. Alaska · Alaska$438.18+$69.84

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 25650 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.15× 1.0003.1500
Practice expense7.54× 0.9837.4118
Malpractice0.66× 0.7060.4660
Total RVUs11.0278
Conversion factor× 33.4009

Office rate, Virginia$368.34

Office: (3.15 × 1 + 7.54 × 0.983 + 0.66 × 0.706) × $33.4009 = $368.34

Facility: (3.15 × 1 + 5.92 × 0.983 + 0.66 × 0.706) × $33.4009 = $315.15

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, Virginia
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.$375.34

How 25650 has changed in Virginia

25650 · Office / nonfacility

$368.34

Effective 2026-10-01

The base rate is $39.15 higher than on 2025-10-01, moving from $329.19 to $368.34 (11.9%).

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

    $329.19changed to$368.34

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $335.82changed to$329.19

    • 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

    $330.34changed to$335.82

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $340.07changed to$330.34

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $341.10changed to$340.07

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $338.69changed to$341.10

    • 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

    $333.54changed to$338.69

    • 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 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $327.09changed to$333.54

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $325.28changed to$327.09

    • 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

    $320.06changed to$325.28

    • 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
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $319.12changed to$320.06

    • 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 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $319.62changed to$319.12

    • 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

    $318.03changed to$319.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $316.60changed to$318.03

    • 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 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $318.28changed to$316.60

    • 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 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $318.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$368.34$315.15RVU26D
2026-07-01$368.34$315.15RVU26C
2026-04-01$368.34$315.15RVU26B
2026-01-01$368.34$315.15RVU26A
2025-10-01$329.19$305.64RVU25D
2025-07-01$329.19$305.64RVU25C
2025-04-01$329.19$305.64RVU25B
2025-01-01$329.19$305.64RVU25A
2024-10-01$335.82$310.92RVU24D
2024-07-01$335.82$310.92RVU24C
2024-04-01$335.82$310.92RVU24B
2024-03-09$335.82$310.92RVU24AR
2024-01-01$330.34$305.85RVU24A
2023-10-01$340.07$314.90RVU23D
2023-07-01$340.07$314.90RVU23C
2023-04-01$340.07$314.90RVU23B
2023-01-01$340.07$314.90RVU23A
2022-10-01$341.10$315.28RVU22D
2022-07-01$341.10$315.28RVU22C
2022-04-01$341.10$315.28RVU22B
2022-01-01$341.10$315.28RVU22A
2021-10-01$338.69$313.34RVU21D
2021-07-01$338.69$313.34RVU21C
2021-04-01$338.69$313.34RVU21B
2021-01-01$338.69$313.34RVU21A
2020-10-01$333.54$310.30RVU20D
2020-07-01$333.54$310.30RVU20C
2020-04-01$333.54$310.30RVU20B
2020-01-01$333.54$310.30RVU20A
2019-10-01$327.09$304.70RVU19D
2019-07-01$327.09$304.70RVU19C
2019-04-01$327.09$304.70RVU19B
2019-01-01$327.09$304.70RVU19A
2018-10-01$325.28$303.98RVU18D
2018-07-01$325.28$303.98RVU18C
2018-04-01$325.28$303.98RVU18B
2018-01-01$325.28$303.98RVU18AR1
2017-10-01$320.06$300.62RVU17D
2017-07-01$320.06$300.62RVU17C
2017-04-01$320.06$300.62RVU17B
2017-01-01$320.06$300.62RVU17A
2016-10-01$319.12$299.41RVU16D
2016-07-01$319.12$299.41RVU16C
2016-04-01$319.12$299.41RVU16B
2016-01-01$319.12$299.41RVU16A
2015-10-01$319.62$299.84RVU15D
2015-07-01$319.62$299.84RVU15C
2015-04-01$318.03$298.34RVU15B
2015-01-01$318.03$298.34RVU15A
2014-10-01$316.60$297.65RVU14D
2014-07-01$316.60$297.65RVU14C
2014-04-01$316.60$297.65RVU14B
2014-01-01$316.60$297.65RVU14A
2013-10-01$318.28$297.67RVU13D
2013-07-01$318.28$297.67RVU13C
2013-04-01$318.28$297.67RVU13B
2013-01-01$318.28$297.67RVU13AR

Price 25650 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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