Billing code 25630: Carpal fracture careMedicare rate & RVUs
Reports closed treatment of a carpal bone fracture other than the scaphoid when the physician treats the fracture without manipulating it.
Medicare pays $345.03 for 25630 nationally in the office and $290.59 in a hospital or facility. Local office rates run $303.61–$447.27.
Medicare rate · 25630
Carpal fracture care
Swap in your local Medicare rate.
- Work RVUs
- 2.95
- Total RVUs
- 10.33
- Global days
- 090
National rate · 2026
$345.03
Office setting, before claim adjustments.
See every locality for 25630 → · 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
What 25630 covers
This service covers closed treatment of a fractured carpal bone other than the scaphoid, without manipulation of the fracture. A hand or orthopedic surgeon commonly provides it for injuries such as a triquetral or hamate fracture, using immobilization and clinical follow-up rather than operative fixation. Treatment may occur in an office, emergency department, or facility setting. The code is reported for each carpal bone treated.
Choose this code when documentation identifies a non-scaphoid carpal fracture and supports treatment without manipulation. Record the injured bone, the treatment plan, and the fracture care provided; use the manipulation code when the physician manipulates the fracture, and the scaphoid-specific code for a scaphoid fracture. The 90-day global includes 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 at 50%. Bilateral reporting with modifier 50 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 25630 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$303.61 to $447.27
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $308.23 | $260.59 |
| Alaska* | $400.36 | $342.38 |
| Arizona | $335.20 | $282.45 |
| Arkansas | $303.61 | $256.84 |
| Atlanta | $352.85 | $297.54 |
| Austin | $356.19 | $298.59 |
| Bakersfield | $361.13 | $301.46 |
| Baltimore/Surr. Cntys | $367.78 | $309.36 |
| Beaumont | $323.21 | $273.67 |
| Brazoria | $339.51 | $285.56 |
| Chicago | $371.94 | $317.23 |
| Chico | $359.52 | $299.85 |
| Colorado | $356.51 | $298.58 |
| Connecticut | $368.56 | $309.92 |
| Dallas | $342.26 | $288.03 |
| Dc + Md/Va Suburbs | $392.97 | $328.84 |
| Delaware | $340.84 | $287.05 |
| Detroit | $350.37 | $297.83 |
| East St. Louis | $346.50 | $296.42 |
| El Centro | $359.62 | $299.95 |
| Fort Lauderdale | $363.64 | $308.49 |
| Fort Worth | $340.24 | $286.56 |
| Fresno | $359.52 | $299.85 |
| Galveston | $340.90 | $286.84 |
| Hanford-Corcoran | $359.52 | $299.85 |
| Hawaii, Guam | $367.99 | $306.09 |
| Houston | $351.51 | $297.45 |
| Idaho | $316.65 | $266.56 |
| Indiana | $318.49 | $268.02 |
| Iowa | $314.04 | $264.23 |
| Kansas | $313.62 | $264.40 |
| Kentucky | $318.17 | $269.77 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $384.13 | $319.72 |
| Madera | $359.52 | $299.85 |
| Manhattan | $399.48 | $336.22 |
| Merced | $359.52 | $299.85 |
| Metropolitan Boston | $391.00 | $326.00 |
| Metropolitan Kansas City | $330.73 | $279.61 |
| Metropolitan Philadelphia | $359.86 | $303.18 |
| Metropolitan St. Louis | $334.17 | $282.34 |
| Miami | $383.96 | $327.29 |
| Minnesota | $337.98 | $281.96 |
| Mississippi | $308.40 | $261.53 |
| Modesto | $359.52 | $299.85 |
| Montana** | $344.99 | $290.55 |
| Napa | $413.93 | $342.18 |
| Nebraska | $315.49 | $265.24 |
| Nevada** | $342.02 | $287.53 |
| New Hampshire | $351.92 | $295.25 |
| New Mexico | $330.07 | $280.15 |
| New Orleans | $334.27 | $283.03 |
| North Carolina | $322.82 | $272.02 |
| North Dakota** | $333.52 | $279.08 |
| Northern Nj | $388.90 | $325.74 |
| Nyc Suburbs/Long Island | $410.87 | $346.13 |
| Ohio | $325.43 | $275.72 |
| Oklahoma | $316.41 | $267.79 |
| Oxnard-Thousand Oaks-Ventura | $381.82 | $317.47 |
| Portland | $366.86 | $306.37 |
| Poughkpsie/N Nyc Suburbs | $375.11 | $315.49 |
| Puerto Rico | $347.24 | $292.20 |
| Queens | $401.24 | $336.88 |
| Redding | $359.52 | $299.85 |
| Rest Of California | $359.52 | $299.85 |
| Rest Of Florida | $344.78 | $292.73 |
| Rest Of Georgia | $324.22 | $275.66 |
| Rest Of Illinois | $336.18 | $286.47 |
| Rest Of Louisiana | $318.10 | $269.92 |
| Rest Of Maine | $319.54 | $269.45 |
| Rest Of Maryland | $347.15 | $292.06 |
| Rest Of Massachusetts | $354.71 | $297.38 |
| Rest Of Michigan | $327.77 | $278.06 |
| Rest Of Missouri | $313.18 | $266.25 |
| Rest Of New Jersey | $371.75 | $312.30 |
| Rest Of New York | $327.92 | $276.20 |
| Rest Of Oregon | $338.37 | $284.14 |
| Rest Of Pennsylvania | $325.34 | $275.36 |
| Rest Of Texas | $331.57 | $279.90 |
| Rest Of Washington | $353.72 | $296.39 |
| Rhode Island | $352.31 | $296.07 |
| Riverside-San Bernardino-Ontario | $365.76 | $306.09 |
| Sacramento-Roseville-Folsom | $376.61 | $313.29 |
| Salinas | $375.21 | $312.11 |
| San Diego-Chula Vista-Carlsbad | $383.63 | $318.52 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $437.03 | $360.27 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $436.37 | $359.61 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $447.27 | $368.76 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $444.58 | $366.07 |
| San Luis Obispo-Paso Robles | $369.29 | $307.28 |
| Santa Cruz-Watsonville | $386.94 | $320.79 |
| Santa Maria-Santa Barbara | $376.50 | $313.02 |
| Santa Rosa-Petaluma | $390.78 | $323.93 |
| Seattle (King Cnty) | $397.97 | $331.17 |
| South Carolina | $324.86 | $274.56 |
| South Dakota** | $332.17 | $277.72 |
| Southern Maine | $335.84 | $281.89 |
| Stockton | $359.52 | $299.85 |
| Suburban Chicago | $366.81 | $310.90 |
| Tennessee | $315.39 | $265.90 |
| Utah | $329.43 | $278.25 |
| Vallejo | $412.98 | $341.23 |
| Vermont | $333.19 | $279.29 |
| Virgin Islands | $347.24 | $292.20 |
| Virginia | $335.47 | $281.96 |
| Visalia | $359.52 | $299.85 |
| West Virginia | $323.63 | $276.32 |
| Wisconsin | $322.09 | $269.93 |
| Wyoming** | $339.99 | $285.55 |
| Yuba City | $359.52 | $299.85 |
25630 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$303.61
$403.40
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $400.36 | 1 |
| AL | $308.23 | 1 |
| AR | $303.61 | 1 |
| AZ | $335.20 | 1 |
| CA | $359.52–$447.27 | 29 |
| CO | $356.51 | 1 |
| CT | $368.56 | 1 |
| DC | $392.97 | 1 |
| DE | $340.84 | 1 |
| FL | $344.78–$383.96 | 3 |
| GA | $324.22–$352.85 | 2 |
| GU | $367.99 | 1 |
| HI | $367.99 | 1 |
| IA | $314.04 | 1 |
| ID | $316.65 | 1 |
| IL | $336.18–$371.94 | 4 |
| IN | $318.49 | 1 |
| KS | $313.62 | 1 |
| KY | $318.17 | 1 |
| LA | $318.10–$334.27 | 2 |
| MA | $354.71–$391.00 | 2 |
| MD | $347.15–$392.97 | 3 |
| ME | $319.54–$335.84 | 2 |
| MI | $327.77–$350.37 | 2 |
| MN | $337.98 | 1 |
| MO | $313.18–$334.17 | 3 |
| MS | $308.40 | 1 |
| MT | $344.99 | 1 |
| NC | $322.82 | 1 |
| ND | $333.52 | 1 |
| NE | $315.49 | 1 |
| NH | $351.92 | 1 |
| NJ | $371.75–$388.90 | 2 |
| NM | $330.07 | 1 |
| NV | $342.02 | 1 |
| NY | $327.92–$410.87 | 5 |
| OH | $325.43 | 1 |
| OK | $316.41 | 1 |
| OR | $338.37–$366.86 | 2 |
| PA | $325.34–$359.86 | 2 |
| PR | $347.24 | 1 |
| RI | $352.31 | 1 |
| SC | $324.86 | 1 |
| SD | $332.17 | 1 |
| TN | $315.39 | 1 |
| TX | $323.21–$356.19 | 8 |
| UT | $329.43 | 1 |
| VA | $335.47–$392.97 | 2 |
| VI | $347.24 | 1 |
| VT | $333.19 | 1 |
| WA | $353.72–$397.97 | 2 |
| WI | $322.09 | 1 |
| WV | $323.63 | 1 |
| WY | $339.99 | 1 |
How the 25630 rate is calculated
Each of 25630’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 · 25630
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.95Practice expense 6.80Malpractice 0.58
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25630
25630 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25630
Carpal fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25630
Carpal fracture care
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25630 without 50 · national office
$345.03
Carpal fracture care
25630-50 · Bilateral: 150%
$517.55
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).
25630 compared with similar codes
Compare codes
25630 vs 25635 vs 25622 vs 25624 vs 25645: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25635Carpal fracture treatment
- Both address closed treatment of a non-scaphoid carpal fracture. Select 25630 when no manipulation is performed and 25635 when the physician manipulates the fracture.
- 25622Scaphoid fracture care
- 25622 is for a scaphoid fracture treated without manipulation. Use 25630 for another carpal bone treated without manipulation.
- 25624Scaphoid fracture care
- 25624 covers closed treatment of a scaphoid fracture with manipulation; 25630 covers a non-scaphoid carpal fracture without manipulation.
- 25645Carpal fracture repair
- 25645 is for open treatment of a non-scaphoid carpal fracture. This code describes closed treatment without manipulation.
25630 billing questions
How does this differ from 25635?
Use 25630 when the non-scaphoid carpal fracture is treated without manipulation. Use 25635 when the physician manipulates the fracture as part of closed treatment.
Can 25630 be used for a scaphoid fracture?
No. The scaphoid has its own closed-treatment codes: 25622 without manipulation and 25624 with manipulation.
How many units should be reported?
The code is reported for each carpal bone treated. Documentation should identify each treated bone when more than one is involved.
Are routine fracture follow-up visits separately reported?
Related postoperative care during the 90-day global period is included. The global also includes the day-before preoperative visit.
How is bilateral treatment handled?
For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be billed?
Assistant-at-surgery payment is restricted for this code. 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
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