No office rate
Both address a trans-scaphoid perilunate fracture-dislocation, but 25680 is for closed treatment with manipulation; 25685 is for open treatment.
On this page
CMS RVU26D · Effective 2026-10-01
25685 Wrist fracture-dislocation Medicare reimbursement rates in Missouri
Reported for open surgical treatment of a perilunate wrist fracture-dislocation that extends through the scaphoid, including internal fixation when performed. Compare 25685 office and facility rates across CMS payment localities in Missouri.
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 25685 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$649.16–$677.48
3 of 3 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.
Where 25685 pays more and less in Missouri
Orthopedic surgery
About 25685: Open trans-scaphoid perilunate fracture-dislocation treatment
Reported for open surgical treatment of a perilunate wrist fracture-dislocation that extends through the scaphoid, including internal fixation when performed.
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.
CMS billing rules for 25685
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.84 · 48%
- Practice expense (office) RVU8.77 · 42%
- Malpractice RVU2.09 · 10%
20
Medicare services in 2024 · #5910 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.
25685 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 25628 for open treatment of a scaphoid fracture without the perilunate dislocation. Code 25685 describes the combined fracture-dislocation injury.
No office rate
Code 25695 is for open treatment of a lunate dislocation. Code 25685 applies when the perilunate injury also includes a fracture through the scaphoid.
Compare 25685 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$671.92
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$677.48
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$649.16
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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 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.
2,50325675,,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
2,50925800,,Arthrd wrist complete wo grf,A,,9.82,8.46,NA,8.46,,1.88,20.16,20.16,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00