No office rate
Use 25680 for closed reduction by manipulation of the trans-scaphoid perilunate fracture-dislocation; use 25685 when the injury is treated through an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
25680 Wrist fracture care Medicare reimbursement rates in Kentucky
Reports closed reduction by manipulation of a perilunate wrist fracture-dislocation that passes through the scaphoid, with related fracture care included in the global period. Compare 25680 office and facility rates across CMS payment localities in Kentucky.
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 25680 in Kentucky?
Kentucky 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
$485.07
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Wrist fracture care
About 25680: Closed trans-scaphoid perilunate fracture-dislocation treatment
Reports closed reduction by manipulation of a perilunate wrist fracture-dislocation that passes through the scaphoid, with related fracture care included in the global period.
This service treats a carpal fracture-dislocation in which the scaphoid is fractured and the carpal bones are displaced around the lunate. The physician manipulates the wrist to restore alignment without surgically exposing the fracture, then immobilizes it. Orthopedic and hand surgeons commonly perform the reduction in a hospital or other procedural setting, often with imaging guidance.
Report this code when the documented injury pattern is a trans-scaphoid perilunate fracture-dislocation and the physician performs closed treatment with manipulation. The record should identify the fracture-dislocation, side, reduction performed, and resulting alignment; imaging and the treatment plan support the service. This major surgery code has a 90-day global period that includes 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 multiple-procedure reduction. Modifier 50 applies to bilateral performance, with payment at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25680
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.07 · 39%
- Practice expense (office) RVU8.17 · 53%
- Malpractice RVU1.30 · 8%
37
Medicare services in 2024 · #5536 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.
25680 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$506.27
Code 25624 is for a scaphoid fracture treated closed with manipulation, without the perilunate fracture-dislocation pattern.
No office rate
Code 25690 addresses a lunate dislocation treated closed with manipulation. Code 25680 requires the associated scaphoid fracture and perilunate injury pattern.
Compare 25680 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$485.07
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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 25680 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,505
- Code
- 25680
- Physician work
- 6.07
- Practice expense
- 8.17
- Malpractice
- 1.30
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.07 | × 1.000 | 6.0700 |
| Practice expense | 8.17 | × 0.889 | 7.2631 |
| Malpractice | 1.30 | × 0.915 | 1.1895 |
| Total RVUs | 14.5226 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$485.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.07 | 1 |
| Practice expense | 8.17 | 0.889 |
| Malpractice | 1.3 | 0.915 |
(6.07 × 1 + 8.17 × 0.889 + 1.3 × 0.915) × $33.4009 = $485.07
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.
25680 billing questions
How is this different from code 25685?
Code 25680 is for closed treatment with manipulation. Code 25685 is for open treatment of the trans-scaphoid perilunate fracture-dislocation.
Can this code be used for an isolated scaphoid fracture?
No. It describes the combined fracture-dislocation pattern involving the scaphoid and perilunate alignment. An isolated scaphoid fracture may fit a different treatment code, such as 25624 when closed treatment with manipulation is performed.
Is the reduction reported separately from the fracture treatment?
The manipulation is part of the closed fracture-dislocation treatment represented by this code. Related postoperative care falls within its 90-day global period.
What documentation supports reporting this code?
Document the trans-scaphoid perilunate fracture-dislocation, the affected side, the closed manipulation performed, and the reduction result. Imaging and the immobilization and follow-up plan can support the record.
How are bilateral cases and multiple procedures handled?
For bilateral performance, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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.
2,50225671,,Perq skel fix rad/uln dislc,A,,6.30,8.02,NA,8.02,,1.33,15.65,15.65,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50325675,,Cltx dstl rad/uln dislc mnpj,A,,4.77,11.46,,8.75,,1.13,17.36,14.65,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50425676,,Optx rad/uln dislc aqt/chrnc,A,,8.08,8.13,NA,8.13,,1.61,17.82,17.82,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50525680,,Cltx trns-scphprlnr fx mnpj,A,,6.07,8.17,NA,8.17,,1.30,15.54,15.54,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50625685,,Optx trns-scphprlnr fx dislc,A,,9.84,8.77,NA,8.77,,2.09,20.70,20.70,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50725690,,Cltx lunate dislc w/mnpj,A,,5.58,7.66,NA,7.66,,1.20,14.44,14.44,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,50825695,,Optx lunate dislocation,A,,8.30,7.93,NA,7.93,,1.76,17.99,17.99,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631