No office rate
Use 25431 for a nonunion in a carpal bone other than the scaphoid. Use 25440 when the nonunion is in the scaphoid.
On this page
CMS RVU26D · Effective 2026-10-01
25431 Carpal bone repair Medicare reimbursement rates in Alabama
Repair a nonunion in a carpal bone other than the scaphoid, with or without internal fixation, when operative treatment is performed. Compare 25431 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 25431 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$667.49
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 25431: Nonunion repair of a carpal bone
Repair a nonunion in a carpal bone other than the scaphoid, with or without internal fixation, when operative treatment is performed.
This code describes operative repair of a carpal bone that has failed to unite, excluding the scaphoid. The surgeon addresses the persistent nonunion and may use internal fixation; the code covers repair whether or not fixation is used. It is distinct from treatment directed at a scaphoid nonunion and from procedures on the radius or ulna. These operations are generally performed by orthopedic or hand surgeons in a surgical setting.
Report the code when the operative target is a nonunion of a non-scaphoid carpal bone. The operative report should identify the bone and document the nonunion and the repair performed, including fixation when used. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. 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 bilateral repair, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25431
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.62 · 48%
- Practice expense (office) RVU9.24 · 42%
- Malpractice RVU2.26 · 10%
23
Medicare services in 2024 · #5837 by national volume
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.
25431 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Code 25430 describes placement of a vascularized pedicle graft into a carpal bone. Code 25431 describes repair of a non-scaphoid carpal bone nonunion.
No office rate
Code 25405 addresses repair with grafting for a radius or ulna nonunion. Code 25431 applies to a non-scaphoid carpal bone.
Compare 25431 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$667.49
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 25431 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,456
- Code
- 25431
- Physician work
- 10.62
- Practice expense
- 9.24
- Malpractice
- 2.26
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.62 | × 1.000 | 10.6200 |
| Practice expense | 9.24 | × 0.875 | 8.0850 |
| Malpractice | 2.26 | × 0.566 | 1.2792 |
| Total RVUs | 19.9842 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$667.49
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.62 | 1 |
| Practice expense | 9.24 | 0.875 |
| Malpractice | 2.26 | 0.566 |
(10.62 × 1 + 9.24 × 0.875 + 2.26 × 0.566) × $33.4009 = $667.49
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
25431 billing questions
How is this code distinguished from 25440?
This code is for a nonunion of a carpal bone other than the scaphoid. Code 25440 is the corresponding repair code when the nonunion involves the scaphoid.
Does the code include internal fixation?
The repair is reported with or without internal fixation. The operative note should describe the nonunion repair and identify fixation if it was used.
Can this be reported with another procedure performed in the same session?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
How is bilateral repair reported?
For bilateral repair, report modifier 50; the CMS payment rule for this code is 150%.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What documentation supports reporting this code?
Document the affected carpal bone, its nonunion, and the operative repair performed. Make clear that the treated bone is not the scaphoid.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,45325425,,Repair/graft radius or ulna,A,,13.38,10.45,NA,10.45,,2.85,26.68,26.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45425426,,Repair/graft radius & ulna,A,,16.04,11.30,NA,11.30,,3.41,30.75,30.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45525430,,Vasc graft into carpal bone,A,,9.47,9.33,NA,9.33,,2.02,20.82,20.82,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45625431,,Repair nonunion carpal bone,A,,10.62,9.24,NA,9.24,,2.26,22.12,22.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45725440,,Repair nonu scphd carpl b1,A,,10.41,8.69,NA,8.69,,2.00,21.10,21.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45825441,,Arthrp w/prostc dstl rds,A,,12.96,10.31,NA,10.31,,2.75,26.02,26.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45925442,,Arthrp w/prostc dstl ulna,A,,10.84,9.28,NA,9.28,,2.05,22.17,22.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515