Billing code 25685: Wrist fracture-dislocationMedicare rate & RVUs in Guam
Reported for open surgical treatment of a perilunate wrist fracture-dislocation that extends through the scaphoid, including internal fixation when performed.
CMS doesn’t publish an office rate for 25685 in Guam.
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 25685 covers
This code represents open surgical treatment of a perilunate fracture-dislocation that passes through the scaphoid, a carpal bone on the thumb side of the wrist. The surgeon exposes the injury to restore carpal alignment and treat the scaphoid fracture; internal fixation is included when performed. Orthopedic and hand surgeons typically perform this operation in a hospital or ambulatory surgery setting for an unstable or displaced injury requiring open treatment.
Select the code when the operative record supports both the trans-scaphoid fracture and the perilunate dislocation, and documents open treatment. The CMS global period is 90 days, 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 other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.
25685 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $702.14 |
How the 25685 rate is calculated
Each of 25685’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 · 25685
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.84Practice expense 8.77Malpractice 2.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25685
25685 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25685
Wrist fracture-dislocation
| 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) | 2 | Paid. |
| 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 · 25685
Wrist fracture-dislocation
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
25685 without 50 · national facility
$691.40
Wrist fracture-dislocation
25685-50 · Bilateral: 150%
$1,037.10
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).
25685 compared with similar codes
Compare codes
25685 vs 25680 vs 25628 vs 25695: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25680Wrist fracture care
- Both address a trans-scaphoid perilunate fracture-dislocation, but 25680 is for closed treatment with manipulation; 25685 is for open treatment.
- 25628Scaphoid fixation
- Use 25628 for open treatment of a scaphoid fracture without the perilunate dislocation. Code 25685 describes the combined fracture-dislocation injury.
- 25695Lunate dislocation
- Code 25695 is for open treatment of a lunate dislocation. Code 25685 applies when the perilunate injury also includes a fracture through the scaphoid.
25685 billing questions
How does this differ from 25680?
Use 25685 for open treatment of the trans-scaphoid perilunate fracture-dislocation. Code 25680 describes closed treatment with manipulation of that injury.
Is scaphoid fixation separately reported?
Internal fixation of the scaphoid fracture is included when performed as part of this treatment. Do not separately report fixation of that same fracture.
What documentation supports code selection?
The operative report should establish a fracture through the scaphoid with an associated perilunate dislocation and describe open treatment.
Can an assistant-at-surgery claim be submitted?
CMS permits payment for an assistant at surgery for this code, subject to applicable claim requirements.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple-procedure reduction.
How is bilateral treatment reported?
When the procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS rule for this code.
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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