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CPT code 25685: Wrist fracture-dislocation, open treatment2026 Medicare rate & RVUs

Reported for open surgical treatment of a perilunate wrist fracture-dislocation that extends through the scaphoid, including internal fixation when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities20 Medicare services in 2024

Medicare pays $691.40 for 25685 nationally in a facility.

Medicare rate · 25685

Wrist fracture-dislocation, open treatment

Office or facility?

Work RVUs
9.84
Total RVUs
20.70
Global days
090

National rate · 2026

$691.40

Facility setting, before claim adjustments.

See every locality for 25685 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 25685 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 25685 covers

This code represents open surgical treatment of a perilunate fracture-dislocation that passes through the scaphoid, a carpal bone on the thumb side of the wrist. The surgeon exposes the injury to restore carpal alignment and treat the scaphoid fracture; internal fixation is included when performed. Orthopedic and hand surgeons typically perform this operation in a hospital or ambulatory surgery setting for an unstable or displaced injury requiring open treatment.

Select the code when the operative record supports both the trans-scaphoid fracture and the perilunate dislocation, and documents open treatment. The CMS global period is 90 days, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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 25685 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

25685 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$624.49
AlaskaUnavailable$843.43
ArizonaUnavailable$672.27
ArkansasUnavailable$616.24
Atlanta, GAUnavailable$711.10
Austin, TXUnavailable$701.09
Bakersfield, CAUnavailable$698.47
Baltimore area, MDUnavailable$734.59
Beaumont, TXUnavailable$660.08
Brazoria, TXUnavailable$676.03

25685 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
25685 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 25685 rate is calculated

Each of 25685’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 · 25685

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.84

9.84 RVUs× 1.000 GPCI

Practice expense8.77

8.77 RVUs× 1.000 GPCI

Malpractice2.09

2.09 RVUs× 1.000 GPCI

Adjusted RVUs

20.7000

Conversion factor

$33.4009

Medicare rate

$691.40

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 25685

25685 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25685

Wrist fracture-dislocation, open treatment

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)2Paid.
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 · 25685

Wrist fracture-dislocation, open treatment

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

25685 without 50 · national facility

$691.40

Wrist fracture-dislocation, open treatment

25685-50 · Bilateral: 150%

$1,037.10

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

25685 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 25685

    Wrist fracture-dislocation, open treatment9.84 wRVU

    Not priced

  • 25680

    Wrist fracture care, trans-scaphoid perilunate injury6.07 wRVU

    Not priced

  • 25628

    Scaphoid fixation, open treatment with fixation9.43 wRVU

    Not priced

  • 25695

    Lunate dislocation, open treatment8.3 wRVU

    Not priced

How to choose

25680Wrist fracture careTrans-scaphoid perilunate injury
Both address a trans-scaphoid perilunate fracture-dislocation, but 25680 is for closed treatment with manipulation; 25685 is for open treatment.
25628Scaphoid fixationOpen treatment with fixation
Use 25628 for open treatment of a scaphoid fracture without the perilunate dislocation. Code 25685 describes the combined fracture-dislocation injury.
25695Lunate dislocationOpen treatment
Code 25695 is for open treatment of a lunate dislocation. Code 25685 applies when the perilunate injury also includes a fracture through the scaphoid.

Codes related to 25685

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

Codes related to 25685
CodeHow it relatesNational office range
Same family
25680Wrist fracture care, trans-scaphoid perilunate injuryClosed treatment with manipulation of the trans-scaphoid perilunate fracture-dislocation.No office rate
Used instead
25628Scaphoid fixation, open treatment with fixationOpen fixation for an isolated scaphoid fracture without the perilunate fracture-dislocation.No office rate
25690Lunate reduction, closed, with manipulationClosed treatment with manipulation for a lunate dislocation rather than a trans-scaphoid fracture-dislocation.No office rate
25695Lunate dislocation, open treatmentOpen treatment for a lunate dislocation without the trans-scaphoid fracture component.No office rate

25685 billing questions

How does this differ from 25680?

Use 25685 for open treatment of the trans-scaphoid perilunate fracture-dislocation. Code 25680 describes closed treatment with manipulation of that injury.

Is scaphoid fixation separately reported?

Internal fixation of the scaphoid fracture is included when performed as part of this treatment. Do not separately report fixation of that same fracture.

What documentation supports code selection?

The operative report should establish a fracture through the scaphoid with an associated perilunate dislocation and describe open treatment.

Can an assistant-at-surgery claim be submitted?

CMS permits payment for an assistant at surgery for this code, subject to applicable claim requirements.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple-procedure reduction.

How is bilateral treatment reported?

When the procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS rule for this code.

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 25685PPRRVU2026_Oct_nonQPP.csv, line 2,506 (RVU26D)

Open CMS sourceHow we calculate rates

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