$490.30–$533.03
Both address closed treatment of a non-scaphoid carpal fracture. Select 25630 when no manipulation is performed and 25635 when the physician manipulates the fracture.
On this page
CMS RVU26D · Effective 2026-10-01
25630 Carpal fracture care Medicare reimbursement rates in Georgia
Reports closed treatment of a carpal bone fracture other than the scaphoid when the physician treats the fracture without manipulating it. Compare 25630 office and facility rates across CMS payment localities in Georgia.
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 25630 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$324.22–$352.85
2 of 2 localities have a supported rate.
Facility setting
$275.66–$297.54
2 of 2 localities have a supported rate.
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 fracture care
About 25630: Closed treatment of non-scaphoid carpal fracture
Reports closed treatment of a carpal bone fracture other than the scaphoid when the physician treats the fracture without manipulating it.
This service covers closed treatment of a fractured carpal bone other than the scaphoid, without manipulation of the fracture. A hand or orthopedic surgeon commonly provides it for injuries such as a triquetral or hamate fracture, using immobilization and clinical follow-up rather than operative fixation. Treatment may occur in an office, emergency department, or facility setting. The code is reported for each carpal bone treated.
Choose this code when documentation identifies a non-scaphoid carpal fracture and supports treatment without manipulation. Record the injured bone, the treatment plan, and the fracture care provided; use the manipulation code when the physician manipulates the fracture, and the scaphoid-specific code for a scaphoid fracture. The 90-day global includes 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 25630
- 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 RVU2.95 · 29%
- Practice expense (office) RVU6.80 · 66%
- Malpractice RVU0.58 · 6%
2K
Medicare services in 2024 · #2464 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.
25630 compared with similar codes
Office rates for Georgia, from the same CMS release.
$328.06–$358.48
25622 is for a scaphoid fracture treated without manipulation. Use 25630 for another carpal bone treated without manipulation.
$516.60–$562.06
25624 covers closed treatment of a scaphoid fracture with manipulation; 25630 covers a non-scaphoid carpal fracture without manipulation.
No office rate
25645 is for open treatment of a non-scaphoid carpal fracture. This code describes closed treatment without manipulation.
Compare 25630 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$352.85
Facility
$297.54
Rest Of Georgia →
Office / nonfacility
$324.22
Facility
$275.66
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25630 billing questions
How does this differ from 25635?
Use 25630 when the non-scaphoid carpal fracture is treated without manipulation. Use 25635 when the physician manipulates the fracture as part of closed treatment.
Can 25630 be used for a scaphoid fracture?
No. The scaphoid has its own closed-treatment codes: 25622 without manipulation and 25624 with manipulation.
How many units should be reported?
The code is reported for each carpal bone treated. Documentation should identify each treated bone when more than one is involved.
Are routine fracture follow-up visits separately reported?
Related postoperative care during the 90-day global period is included. The global also includes the day-before preoperative visit.
How is bilateral treatment handled?
For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be billed?
Assistant-at-surgery payment is restricted for this code. 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 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.
2,49125622,,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
2,49725650,,Cltx ulnar styloid fracture,A,,3.15,7.54,,5.92,,0.66,11.35,9.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00