No office rate
25431 describes carpal-bone nonunion repair. Use 25430 when the operative report documents transfer of a vascularized graft into the carpal bone.
On this page
CMS RVU26D · Effective 2026-10-01
25430 Carpal bone graft Medicare reimbursement rates in Connecticut
Reports transfer of a vascularized bone graft to a carpal bone, commonly to address scaphoid nonunion or compromised bone viability. Compare 25430 office and facility rates across CMS payment localities in Connecticut.
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 25430 in Connecticut?
Connecticut 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
$739.90
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 25430: Vascularized carpal bone graft
Reports transfer of a vascularized bone graft to a carpal bone, commonly to address scaphoid nonunion or compromised bone viability.
A hand or wrist surgeon transfers bone with its blood supply to a carpal bone. A common clinical setting is a scaphoid nonunion with impaired blood supply; the operative report should identify the carpal bone treated and explain the reason for using a vascularized graft. These procedures are generally performed in a hospital operating room.
Select this code when the documented operation places a vascularized graft into a carpal bone, rather than using a nonvascularized repair approach or treating the radius or ulna. Document the graft transfer, treated site, indication, and any fixation performed. Medicare assigns a 90-day global period, including 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 are subject to the standard 50% reduction. Modifier 50 indicates bilateral performance and is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 25430
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.47 · 45%
- Practice expense (office) RVU9.33 · 45%
- Malpractice RVU2.02 · 10%
15
Medicare services in 2024 · #6062 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.
25430 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
25440 is directed to scaphoid nonunion repair. The vascularized graft transfer documented for 25430 is the distinguishing operative work.
No office rate
25405 concerns repair or grafting of the radius or ulna; 25430 is for vascularized graft placement into a carpal bone.
Compare 25430 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$739.90
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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 25430 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
2,455
- Code
- 25430
- Physician work
- 9.47
- Practice expense
- 9.33
- Malpractice
- 2.02
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.47 | × 1.020 | 9.6594 |
| Practice expense | 9.33 | × 1.077 | 10.0484 |
| Malpractice | 2.02 | × 1.210 | 2.4442 |
| Total RVUs | 22.1520 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$739.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.47 | 1.02 |
| Practice expense | 9.33 | 1.077 |
| Malpractice | 2.02 | 1.21 |
(9.47 × 1.02 + 9.33 × 1.077 + 2.02 × 1.21) × $33.4009 = $739.90
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.
25430 billing questions
When should this code be chosen over 25431?
Choose 25430 when the surgeon transfers a vascularized graft into a carpal bone. Code 25431 describes repair of a carpal-bone nonunion and is the closer choice when the documented procedure is that repair rather than vascularized graft transfer.
How does this differ from 25440?
Code 25440 addresses repair of a scaphoid nonunion. Use 25430 when the operative work specifically includes vascularized graft transfer to a carpal bone.
What documentation supports reporting 25430?
The operative report should identify the carpal bone and indication, describe transfer of the vascularized graft, and document any fixation performed.
Can modifier 50 be used for bilateral surgery?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
How are assistants and co-surgeons handled?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,45225420,,Repair/graft radius & ulna,A,,16.61,11.84,NA,11.84,,3.54,31.99,31.99,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45325425,,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
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808