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Billing code 25440: Scaphoid repairMedicare rate & RVUs

Repair a scaphoid fracture nonunion, typically with bone grafting and fixation, when an orthopedic surgeon reconstructs the unhealed carpal bone.

CMS RVU26DEffective Oct 1, 2026109 payment localities144 Medicare services in 2024

Medicare pays $704.76 for 25440 nationally in a facility.

Medicare rate · 25440

Scaphoid repair

Work RVUs
10.41
Total RVUs
21.10
Global days
090

National rate · 2026

$704.76

Facility setting, before claim adjustments.

See every locality for 25440 →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 25440 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 25440 covers

This service repairs a scaphoid fracture that has failed to unite. An orthopedic or hand surgeon may prepare the nonunion site and stabilize the scaphoid; bone grafting may be part of the reconstruction. It is generally performed in an operating room for a patient with persistent symptoms or impaired wrist function after a scaphoid fracture. The operative report should identify the scaphoid and document the nonunion repair and techniques used.

Report the code for repair of a scaphoid nonunion; internal fixation or graft use does not by itself change the selection to a repair code for another carpal bone. The 90-day global period includes 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% reduction. For a bilateral procedure reported with modifier 50, CMS pays 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is 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 25440 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

25440 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$639.49
Alaska*Unavailable$867.48
ArizonaUnavailable$686.14
ArkansasUnavailable$631.43
AtlantaUnavailable$723.87
AustinUnavailable$714.67
BakersfieldUnavailable$713.11
Baltimore/Surr. CntysUnavailable$747.34
BeaumontUnavailable$673.89
BrazoriaUnavailable$690.23

25440 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
25440 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 25440 rate is calculated

Each of 25440’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 · 25440

RVUs × geographic indexes × conversion factor

Work10.41

10.41 RVUs× 1.000 GPCI

Practice expense8.69

8.69 RVUs× 1.000 GPCI

Malpractice2.00

2.00 RVUs× 1.000 GPCI

Adjusted RVUs

21.1000

Conversion factor

$33.4009

Medicare rate

$704.76

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

Payment rules and modifiers for 25440

25440 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25440

Scaphoid repair

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)1Permitted with supporting documentation.
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 · 25440

Scaphoid repair

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

25440 without 50 · national facility

$704.76

Scaphoid repair

25440-50 · Bilateral: 150%

$1,057.14

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

25440 compared with similar codes

Compare codes · National

4 codes, side by side

  • 25440

    Scaphoid repair10.41 wRVU

    Not priced

  • 25431

    Carpal bone repair10.62 wRVU

    Not priced

  • 25430

    Carpal bone graft9.47 wRVU

    Not priced

  • 25400

    Forearm bone repair11 wRVU

    Not priced

How to choose

25431Carpal bone repair
Choose 25440 for a scaphoid nonunion. Code 25431 applies to nonunion repair of another carpal bone.
25430Carpal bone graft
This code reports repair of a scaphoid nonunion. Code 25430 describes a vascularized bone-graft procedure for a carpal bone.
25400Forearm bone repair
This code treats a scaphoid nonunion; 25400 treats nonunion or malunion of the radius or ulna.

Codes related to 25440

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

Codes related to 25440
CodeHow it relatesNational office range
Same family
25431Carpal bone repairRepair of nonunion in a carpal bone other than the scaphoid.No office rate
Used instead
25430Carpal bone graftDescribes vascularized bone grafting into a carpal bone rather than scaphoid nonunion repair.No office rate
25400Forearm bone repairNonunion repair for the radius or ulna, not the scaphoid.No office rate
25405Forearm bone repairRadius or ulna nonunion repair with grafting, rather than scaphoid repair.No office rate

25440 billing questions

How is this code distinguished from 25431?

This code is for repair of a scaphoid nonunion. Code 25431 is for nonunion repair of another carpal bone.

Does the use of fixation change code selection?

No. Select this code based on repair of the scaphoid nonunion; fixation may be used as part of that repair.

Should bone graft use be documented?

Yes. The operative report should describe whether grafting was performed and the repair technique, along with the scaphoid nonunion being treated.

What postoperative care is included?

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

How are multiple procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the other procedures.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is 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 25440PPRRVU2026_Oct_nonQPP.csv, line 2,457 (RVU26D)

Open CMS sourceHow we calculate rates

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