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Billing code 25430: Carpal bone graftMedicare rate & RVUs

Reports transfer of a vascularized bone graft to a carpal bone, commonly to address scaphoid nonunion or compromised bone viability.

CMS RVU26DEffective Oct 1, 2026109 payment localities15 Medicare services in 2024

Medicare pays $695.41 for 25430 nationally in a facility.

Medicare rate · 25430

Carpal bone graft

Work RVUs
9.47
Total RVUs
20.82
Global days
090

National rate · 2026

$695.41

Facility setting, before claim adjustments.

See every locality for 25430 →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.

On this page 10 sections
  1. Medicare rate
  2. What 25430 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 25430 covers

A hand or wrist surgeon transfers bone with its blood supply to a carpal bone. A common clinical setting is a scaphoid nonunion with impaired blood supply; the operative report should identify the carpal bone treated and explain the reason for using a vascularized graft. These procedures are generally performed in a hospital operating room.

Select this code when the documented operation places a vascularized graft into a carpal bone, rather than using a nonvascularized repair approach or treating the radius or ulna. Document the graft transfer, treated site, indication, and any fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 indicates bilateral performance and is paid at 150%. Assistant-at-surgery payment is 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.

Where 25430 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

25430 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$627.17
Alaska*Unavailable$843.52
ArizonaUnavailable$676.03
ArkansasUnavailable$618.74
AtlantaUnavailable$714.90
AustinUnavailable$706.42
BakersfieldUnavailable$704.95
Baltimore/Surr. CntysUnavailable$739.21
BeaumontUnavailable$662.57
BrazoriaUnavailable$680.29

25430 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
25430 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 25430 rate is calculated

Each of 25430’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 · 25430

RVUs × geographic indexes × conversion factor

Work9.47

9.47 RVUs× 1.000 GPCI

Practice expense9.33

9.33 RVUs× 1.000 GPCI

Malpractice2.02

2.02 RVUs× 1.000 GPCI

Adjusted RVUs

20.8200

Conversion factor

$33.4009

Medicare rate

$695.41

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

Payment rules and modifiers for 25430

25430 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25430

Carpal bone graft

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 · 25430

Carpal bone graft

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

25430 without 50 · national facility

$695.41

Carpal bone graft

25430-50 · Bilateral: 150%

$1,043.12

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

25430 compared with similar codes

Compare codes · National

4 codes, side by side

  • 25430

    Carpal bone graft9.47 wRVU

    Not priced

  • 25431

    Carpal bone repair10.62 wRVU

    Not priced

  • 25440

    Scaphoid repair10.41 wRVU

    Not priced

  • 25405

    Forearm bone repair14.63 wRVU

    Not priced

How to choose

25431Carpal bone repair
25431 describes carpal-bone nonunion repair. Use 25430 when the operative report documents transfer of a vascularized graft into the carpal bone.
25440Scaphoid repair
25440 is directed to scaphoid nonunion repair. The vascularized graft transfer documented for 25430 is the distinguishing operative work.
25405Forearm bone repair
25405 concerns repair or grafting of the radius or ulna; 25430 is for vascularized graft placement into a carpal bone.

Codes related to 25430

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

Codes related to 25430
CodeHow it relatesNational office range
Used instead
25431Carpal bone repairCarpal-bone nonunion repair when the operation is not a vascularized graft transfer.No office rate
25440Scaphoid repairScaphoid nonunion repair; distinguish the documented repair from vascularized graft transfer.No office rate
25405Forearm bone repairGraft repair of the radius or ulna rather than a carpal bone.No office rate

25430 billing questions

When should this code be chosen over 25431?

Choose 25430 when the surgeon transfers a vascularized graft into a carpal bone. Code 25431 describes repair of a carpal-bone nonunion and is the closer choice when the documented procedure is that repair rather than vascularized graft transfer.

How does this differ from 25440?

Code 25440 addresses repair of a scaphoid nonunion. Use 25430 when the operative work specifically includes vascularized graft transfer to a carpal bone.

What documentation supports reporting 25430?

The operative report should identify the carpal bone and indication, describe transfer of the vascularized graft, and document any fixation performed.

Can modifier 50 be used for bilateral surgery?

Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.

How are assistants and co-surgeons handled?

Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 25430PPRRVU2026_Oct_nonQPP.csv, line 2,455 (RVU26D)

Open CMS sourceHow we calculate rates

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