Billing code 25259: Wrist manipulationMedicare rate & RVUs in Florida
Reports passive mobilization of a stiff wrist joint under general anesthesia, typically to improve motion restricted after injury, immobilization, or surgery.
CMS doesn’t publish an office rate for 25259 in Florida.
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 9 sections
What 25259 covers
The surgeon moves the wrist through its range while the patient is under general anesthesia, using controlled force to address restricted joint motion. An orthopedic or hand surgeon commonly performs this procedure in an operating room or other surgical setting when stiffness persists after an injury, a period of immobilization, or prior wrist surgery. The record should identify the affected wrist, the reason motion is restricted, and the manipulation performed; pre- and post-manipulation motion findings help show the work and result.
CMS assigns this major surgery a 90-day global period, including 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 the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery is not paid under the statutory restriction; 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 25259 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $462.17 |
| Miami | Unavailable | $489.01 |
| Rest Of Florida | Unavailable | $438.20 |
How the 25259 rate is calculated
Each of 25259’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 · 25259
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.94Practice expense 8.36Malpractice 0.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25259
25259 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25259
Wrist manipulation
| 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 · 25259
Wrist manipulation
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
25259 without 50 · national facility
$437.22
Wrist manipulation
25259-50 · Bilateral: 150%
$655.83
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).
25259 compared with similar codes
Compare codes
25259 vs 25605 vs 25290: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25605Wrist fracture treatment
- Use 25605 when performing closed treatment with manipulation of a qualifying distal radius fracture. Code 25259 describes manipulation of the wrist joint under general anesthesia, not fracture treatment as such.
- 25290Tendon division
- 25290 involves cutting a wrist or forearm tendon. Use 25259 when the service is passive wrist joint manipulation under general anesthesia rather than tendon incision.
25259 billing questions
When should this code be used instead of a fracture-treatment code?
Use 25259 for manipulation of the wrist joint under general anesthesia. When the manipulation is part of treating a specific fracture, select the applicable fracture-treatment code, which may include the reduction.
What documentation supports reporting the manipulation?
Document the wrist and side, the cause of restricted motion, the pre-manipulation limitation, the manipulation performed, and the resulting motion. The anesthesia record can support that the procedure was performed under general anesthesia.
Does the code include related postoperative visits?
CMS assigns a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.
How does CMS handle bilateral reporting and other procedures in the same session?
With modifier 50, the bilateral procedure is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code under the statutory restriction. 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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