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

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, 2026One payment locality20 Medicare services in 2024

In Nevada, Medicare pays $680.03 for 25685 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$680.03Hospital or facility

Check a contract rate as a % of Medicare · 25685 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 25685 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 25685 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 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.

How Nevada compares for 25685

Across 109 of 109 payment localities, the facility rate for 25685 runs from $616.24 in Arkansas to $843.43 in Alaska. Nevada pays $680.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

25685 in Nevada vs other payment areas
  1. Nevada · this page$680.03
  2. Los Angeles, CA · California$735.02+$54.99
  3. Washington, DC area · District of Columbia$769.18+$89.15
  4. Miami, FL · Florida$810.14+$130.11
  5. Chicago, IL · Illinois$785.57+$105.54
  6. Manhattan, NY · New York$800.79+$120.76
  7. Alaska · Alaska$843.43+$163.40

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

Every other payment area

25685 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$624.49
ArkansasArkansas—$616.24
ArizonaArizona—$672.27
Bakersfield, CACalifornia—$698.47
Chico, CACalifornia—$692.72
El Centro, CACalifornia—$693.07
Fresno, CACalifornia—$692.72
Hanford, CACalifornia—$692.72

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

See 25685 in every payment locality

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.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,506

Code
25685
Physician work
9.84
Practice expense
8.77
Malpractice
2.09

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Facility calculation for 25685 in Nevada
ComponentRVULocality factorAdjusted
Physician work9.84× 1.0009.8400
Practice expense8.77× 1.0018.7788
Malpractice2.09× 0.8331.7410
Total RVUs20.3597
Conversion factor× 33.4009

Facility rate, Nevada$680.03

Facility: (9.84 × 1 + 8.77 × 1.001 + 2.09 × 0.833) × $33.4009 = $680.03

Open 25685 in the RVU calculator

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

How 25685 has changed in Nevada

25685 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$680.03RVU26D
2026-07-01Not available in this setting$680.03RVU26C
2026-04-01Not available in this setting$680.03RVU26B
2026-01-01Not available in this setting$680.03RVU26A
2025-10-01Not available in this setting$720.26RVU25D
2025-07-01Not available in this setting$720.26RVU25C
2025-04-01Not available in this setting$720.26RVU25B
2025-01-01Not available in this setting$720.26RVU25A
2024-10-01Not available in this setting$734.51RVU24D
2024-07-01Not available in this setting$734.51RVU24C
2024-04-01Not available in this setting$734.51RVU24B
2024-03-09Not available in this setting$734.51RVU24AR
2024-01-01Not available in this setting$722.52RVU24A
2023-10-01Not available in this setting$758.70RVU23D
2023-07-01Not available in this setting$758.70RVU23C
2023-04-01Not available in this setting$758.70RVU23B
2023-01-01Not available in this setting$758.70RVU23A
2022-10-01Not available in this setting$785.11RVU22D
2022-07-01Not available in this setting$785.11RVU22C
2022-04-01Not available in this setting$785.11RVU22B
2022-01-01Not available in this setting$785.11RVU22A
2021-10-01Not available in this setting$784.71RVU21D
2021-07-01Not available in this setting$784.71RVU21C
2021-04-01Not available in this setting$784.71RVU21B
2021-01-01Not available in this setting$784.71RVU21A
2020-10-01Not available in this setting$776.57RVU20D
2020-07-01Not available in this setting$776.57RVU20C
2020-04-01Not available in this setting$776.57RVU20B
2020-01-01Not available in this setting$776.57RVU20A
2019-10-01Not available in this setting$764.20RVU19D
2019-07-01Not available in this setting$764.20RVU19C
2019-04-01Not available in this setting$762.56RVU19B
2019-01-01Not available in this setting$762.56RVU19A
2018-10-01Not available in this setting$762.05RVU18D
2018-07-01Not available in this setting$762.05RVU18C
2018-04-01Not available in this setting$762.05RVU18B
2018-01-01Not available in this setting$762.05RVU18AR1
2017-10-01Not available in this setting$763.90RVU17D
2017-07-01Not available in this setting$763.90RVU17C
2017-04-01Not available in this setting$763.90RVU17B
2017-01-01Not available in this setting$763.90RVU17A
2016-10-01Not available in this setting$769.73RVU16D
2016-07-01Not available in this setting$769.73RVU16C
2016-04-01Not available in this setting$769.73RVU16B
2016-01-01Not available in this setting$769.73RVU16A
2015-10-01Not available in this setting$779.08RVU15D
2015-07-01Not available in this setting$779.08RVU15C
2015-04-01Not available in this setting$775.21RVU15B
2015-01-01Not available in this setting$775.21RVU15A
2014-10-01Not available in this setting$773.86RVU14D
2014-07-01Not available in this setting$773.86RVU14C
2014-04-01Not available in this setting$773.86RVU14B
2014-01-01Not available in this setting$773.86RVU14A
2013-10-01Not available in this setting$776.11RVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 25685 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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