$363.33
25622 is closed treatment of a scaphoid fracture without manipulation. Use 25628 when the surgeon opens the site and stabilizes the fracture with internal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
25628 Scaphoid fixation Medicare reimbursement rates in Colorado
Reports open operative treatment of a carpal scaphoid fracture when the surgeon stabilizes the fracture with internal fixation. Compare 25628 office and facility rates across CMS payment localities in Colorado.
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 25628 in Colorado?
Colorado 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
$678.44
1 of 1 localities have a supported rate.
Payment area: Colorado
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 25628: Open scaphoid fracture fixation
Reports open operative treatment of a carpal scaphoid fracture when the surgeon stabilizes the fracture with internal fixation.
An orthopedic or hand surgeon uses an open approach to expose and treat a fractured scaphoid, a carpal bone on the thumb side of the wrist. The surgeon restores fracture alignment as needed and stabilizes the bone with internal fixation, such as a screw. This treatment is commonly performed in an operating room for a displaced or unstable scaphoid fracture when operative fixation is selected.
Report 25628 when the operative record supports open treatment of the scaphoid fracture with internal fixation; closed management or treatment of a different carpal bone calls for a different code. Document the fracture site, operative approach, reduction or alignment work, and fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25628
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.43 · 47%
- Practice expense (office) RVU8.80 · 44%
- Malpractice RVU1.80 · 9%
611
Medicare services in 2024 · #3374 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.
25628 compared with similar codes
Office rates for Colorado, from the same CMS release.
$566.73
25624 is closed treatment of a scaphoid fracture with manipulation. It does not represent open fixation as reported with 25628.
No office rate
25440 addresses repair of an established scaphoid nonunion or malunion. 25628 describes open fixation of a scaphoid fracture, not reconstruction of a nonunion or malunion.
No office rate
25645 is open treatment of a carpal fracture in a bone other than the scaphoid. 25628 is specific to the scaphoid.
Compare 25628 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
Colorado →
Office / nonfacility
Unavailable
Facility
$678.44
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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 25628 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,493
- Code
- 25628
- Physician work
- 9.43
- Practice expense
- 8.80
- Malpractice
- 1.80
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.43 | × 1.012 | 9.5432 |
| Practice expense | 8.80 | × 1.064 | 9.3632 |
| Malpractice | 1.80 | × 0.781 | 1.4058 |
| Total RVUs | 20.3122 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$678.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.43 | 1.012 |
| Practice expense | 8.8 | 1.064 |
| Malpractice | 1.8 | 0.781 |
(9.43 × 1.012 + 8.8 × 1.064 + 1.8 × 0.781) × $33.4009 = $678.44
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.
25628 billing questions
When should 25628 be chosen over closed scaphoid fracture treatment?
Use 25628 when the surgeon treats the scaphoid fracture through an open approach and applies internal fixation. Closed treatment without manipulation or with manipulation is represented by 25622 or 25624, respectively.
Does 25628 describe fixation of any carpal bone?
No. It is specific to open treatment with internal fixation of a scaphoid fracture. Open treatment of a carpal fracture other than the scaphoid is represented by 25645.
What documentation supports reporting 25628?
The operative report should identify the scaphoid fracture and describe the open approach and internal fixation performed. Include the treatment details that distinguish the service from closed management or treatment of another carpal bone.
Are related postoperative visits included?
Yes. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported with 25628?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted under the supplied CMS rules for this code.
How does Medicare handle bilateral reporting and other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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.
2,49025609,,Optx dst rd xart fx/ep sep3+,A,,14.02,12.22,NA,12.22,,2.75,28.99,28.99,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49125622,,Cltx carpl scphd fx w/o mnpj,A,,2.72,7.24,,5.60,,0.54,10.50,8.86,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49225624,,Cltx carpl scphd fx w/mnpj,A,,4.65,10.79,,7.71,,1.00,16.44,13.36,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49325628,,Optx carpl scphd fx int fixj,A,,9.43,8.80,NA,8.80,,1.80,20.03,20.03,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49425630,,Cltx carpl fx w/o mnpj ea b1,A,,2.95,6.80,,5.17,,0.58,10.33,8.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49525635,,Cltx carpl fx w/mnpj ea b1,A,,4.49,10.14,,7.22,,0.96,15.59,12.67,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49625645,,Optx crpl fx oth/thn scph ea,A,,7.23,7.59,NA,7.59,,1.53,16.35,16.35,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899