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CPT 25259: Wrist manipulationMedicare rate & RVUs

Reports passive mobilization of a stiff wrist joint under general anesthesia, typically to improve motion restricted after injury, immobilization, or surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities212 Medicare services in 2024

Medicare pays $437.22 for 25259 nationally in a facility.

Medicare rate · 25259

Wrist manipulation

Swap in your local Medicare rate.

Work RVUs
3.94
Total RVUs
13.09
Global days
090

National rate · 2026

$437.22

Facility setting, before claim adjustments.

See every locality for 25259 →

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

On this page 10 sections
  1. Medicare rate
  2. What 25259 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 25259 covers

The surgeon moves the wrist through its range while the patient is under general anesthesia, using controlled force to address restricted joint motion. An orthopedic or hand surgeon commonly performs this procedure in an operating room or other surgical setting when stiffness persists after an injury, a period of immobilization, or prior wrist surgery. The record should identify the affected wrist, the reason motion is restricted, and the manipulation performed; pre- and post-manipulation motion findings help show the work and result.

CMS assigns this major surgery a 90-day global period, 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 the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery is not paid under the statutory restriction; 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 25259 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

25259 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$390.86
Alaska*Unavailable$509.32
ArizonaUnavailable$424.76
ArkansasUnavailable$385.05
AtlantaUnavailable$447.38
AustinUnavailable$450.67
BakersfieldUnavailable$456.21
Baltimore/Surr. CntysUnavailable$465.96
BeaumontUnavailable$410.21
BrazoriaUnavailable$429.95

25259 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
25259 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 25259 rate is calculated

Each of 25259’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 · 25259

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.94Practice expense 8.36Malpractice 0.79

13.0900 adjusted RVUs×$33.4009 conversion factor=$437.22

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25259

25259 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25259

Wrist 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 · 25259

Wrist 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

25259 without 50 · national facility

$437.22

Wrist manipulation

25259-50 · Bilateral: 150%

$655.83

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

25259 compared with similar codes

Compare codes

25259 vs 25605 vs 25290: national Medicare rates

Swap in your local Medicare rate.

  • 25259
    Wrist manipulation · 3.94 wRVU
    —
  • 25605
    Wrist fracture treatment · 6.09 wRVU
    $634.62
  • 25290
    Tendon division · 5.29 wRVU
    —

How to choose

25605Wrist fracture treatment
Use 25605 when performing closed treatment with manipulation of a qualifying distal radius fracture. Code 25259 describes manipulation of the wrist joint under general anesthesia, not fracture treatment as such.
25290Tendon division
25290 involves cutting a wrist or forearm tendon. Use 25259 when the service is passive wrist joint manipulation under general anesthesia rather than tendon incision.

Codes related to 25259

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

Codes related to 25259
CodeHow it relatesNational office range
Used instead
23700Shoulder manipulationManipulation under anesthesia for the shoulder rather than the wrist.No office rate
24300Elbow manipulationManipulation under anesthesia for the elbow rather than the wrist.No office rate
27570Knee manipulationManipulation under anesthesia for the knee rather than the wrist.No office rate
25605Wrist fracture treatmentFracture-specific closed treatment with manipulation, rather than isolated wrist joint manipulation.$558.08–$806.13

25259 billing questions

When should this code be used instead of a fracture-treatment code?

Use 25259 for manipulation of the wrist joint under general anesthesia. When the manipulation is part of treating a specific fracture, select the applicable fracture-treatment code, which may include the reduction.

What documentation supports reporting the manipulation?

Document the wrist and side, the cause of restricted motion, the pre-manipulation limitation, the manipulation performed, and the resulting motion. The anesthesia record can support that the procedure was performed under general anesthesia.

Does the code include related postoperative visits?

CMS assigns a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.

How does CMS handle bilateral reporting and other procedures in the same session?

With modifier 50, the bilateral procedure is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code under the statutory restriction. 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 25259PPRRVU2026_Oct_nonQPP.csv, line 2,417 (RVU26D)

Open CMS sourceHow we calculate rates

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