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Billing code 25680: Wrist fracture careMedicare rate & RVUs

Reports closed reduction by manipulation of a perilunate wrist fracture-dislocation that passes through the scaphoid, with related fracture care included in the global period.

CMS RVU26DEffective Oct 1, 2026109 payment localities37 Medicare services in 2024

Medicare pays $519.05 for 25680 nationally in a facility.

Medicare rate · 25680

Wrist fracture care

Swap in your local Medicare rate.

Work RVUs
6.07
Total RVUs
15.54
Global days
090

National rate · 2026

$519.05

Facility setting, before claim adjustments.

See every locality for 25680 → · 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 25680 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 25680 covers

This service treats a carpal fracture-dislocation in which the scaphoid is fractured and the carpal bones are displaced around the lunate. The physician manipulates the wrist to restore alignment without surgically exposing the fracture, then immobilizes it. Orthopedic and hand surgeons commonly perform the reduction in a hospital or other procedural setting, often with imaging guidance.

Report this code when the documented injury pattern is a trans-scaphoid perilunate fracture-dislocation and the physician performs closed treatment with manipulation. The record should identify the fracture-dislocation, side, reduction performed, and resulting alignment; imaging and the treatment plan support the service. This major surgery code has a 90-day global period that 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 multiple-procedure reduction. Modifier 50 applies to bilateral performance, with payment at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 25680 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

25680 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$466.09
Alaska*Unavailable$618.66
ArizonaUnavailable$504.34
ArkansasUnavailable$459.51
AtlantaUnavailable$532.75
AustinUnavailable$530.33
BakersfieldUnavailable$532.12
Baltimore/Surr. CntysUnavailable$552.51
BeaumontUnavailable$491.41
BrazoriaUnavailable$508.66

25680 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
25680 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 25680 rate is calculated

Each of 25680’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 · 25680

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.07Practice expense 8.17Malpractice 1.30

15.5400 adjusted RVUs×$33.4009 conversion factor=$519.05

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

Payment rules and modifiers for 25680

25680 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25680

Wrist fracture care

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)0Not paid without supporting documentation.
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 · 25680

Wrist 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.

  • 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

25680 without 50 · national facility

$519.05

Wrist fracture care

25680-50 · Bilateral: 150%

$778.58

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

25680 compared with similar codes

Compare codes

25680 vs 25685 vs 25624 vs 25690: national Medicare rates

Swap in your local Medicare rate.

  • 25680
    Wrist fracture care · 6.07 wRVU
    —
  • 25685
    Wrist fracture-dislocation · 9.84 wRVU
    —
  • 25624
    Scaphoid fracture care · 4.65 wRVU
    $549.11
  • 25690
    Lunate reduction · 5.58 wRVU
    —

How to choose

25685Wrist fracture-dislocation
Use 25680 for closed reduction by manipulation of the trans-scaphoid perilunate fracture-dislocation; use 25685 when the injury is treated through an open approach.
25624Scaphoid fracture care
Code 25624 is for a scaphoid fracture treated closed with manipulation, without the perilunate fracture-dislocation pattern.
25690Lunate reduction
Code 25690 addresses a lunate dislocation treated closed with manipulation. Code 25680 requires the associated scaphoid fracture and perilunate injury pattern.

Codes related to 25680

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

Codes related to 25680
CodeHow it relatesNational office range
Used instead
25685Wrist fracture-dislocationOpen treatment of the same trans-scaphoid perilunate fracture-dislocation.No office rate
25624Scaphoid fracture careClosed treatment with manipulation for an isolated carpal scaphoid fracture.$482.10–$709.99
25628Scaphoid fixationOpen treatment with internal fixation for an isolated carpal scaphoid fracture.No office rate
25690Lunate reductionClosed treatment with manipulation for lunate dislocation without the trans-scaphoid fracture pattern.No office rate

25680 billing questions

How is this different from code 25685?

Code 25680 is for closed treatment with manipulation. Code 25685 is for open treatment of the trans-scaphoid perilunate fracture-dislocation.

Can this code be used for an isolated scaphoid fracture?

No. It describes the combined fracture-dislocation pattern involving the scaphoid and perilunate alignment. An isolated scaphoid fracture may fit a different treatment code, such as 25624 when closed treatment with manipulation is performed.

Is the reduction reported separately from the fracture treatment?

The manipulation is part of the closed fracture-dislocation treatment represented by this code. Related postoperative care falls within its 90-day global period.

What documentation supports reporting this code?

Document the trans-scaphoid perilunate fracture-dislocation, the affected side, the closed manipulation performed, and the reduction result. Imaging and the immobilization and follow-up plan can support the record.

How are bilateral cases and multiple procedures handled?

For bilateral performance, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. 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 25680PPRRVU2026_Oct_nonQPP.csv, line 2,505 (RVU26D)

Open CMS sourceHow we calculate rates

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