Billing code 25430: Carpal bone graftMedicare rate & RVUs in Ohio
Reports transfer of a vascularized bone graft to a carpal bone, commonly to address scaphoid nonunion or compromised bone viability.
CMS doesn’t publish an office rate for 25430 in Ohio.
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 25430 covers
A hand or wrist surgeon transfers bone with its blood supply to a carpal bone. A common clinical setting is a scaphoid nonunion with impaired blood supply; the operative report should identify the carpal bone treated and explain the reason for using a vascularized graft. These procedures are generally performed in a hospital operating room.
Select this code when the documented operation places a vascularized graft into a carpal bone, rather than using a nonvascularized repair approach or treating the radius or ulna. Document the graft transfer, treated site, indication, and any fixation performed. Medicare assigns a 90-day global period, including 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 are subject to the standard 50% reduction. Modifier 50 indicates bilateral performance and is paid at 150%. Assistant-at-surgery payment is restricted; 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.
25430 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $668.83 |
How the 25430 rate is calculated
Each of 25430’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 · 25430
RVUs × geographic indexes × conversion factor
Work9.47
9.47 RVUs× 1.000 GPCI
Practice expense9.33
9.33 RVUs× 1.000 GPCI
Malpractice2.02
2.02 RVUs× 1.000 GPCI
Adjusted RVUs
20.8200
Conversion factor
$33.4009
Medicare rate
$695.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25430
25430 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25430
Carpal bone graft
| 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 · 25430
Carpal bone graft
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
25430 without 50 · national facility
$695.41
Carpal bone graft
25430-50 · Bilateral: 150%
$1,043.12
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).
25430 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25431Carpal bone repair
- 25431 describes carpal-bone nonunion repair. Use 25430 when the operative report documents transfer of a vascularized graft into the carpal bone.
- 25440Scaphoid repair
- 25440 is directed to scaphoid nonunion repair. The vascularized graft transfer documented for 25430 is the distinguishing operative work.
- 25405Forearm bone repair
- 25405 concerns repair or grafting of the radius or ulna; 25430 is for vascularized graft placement into a carpal bone.
25430 billing questions
When should this code be chosen over 25431?
Choose 25430 when the surgeon transfers a vascularized graft into a carpal bone. Code 25431 describes repair of a carpal-bone nonunion and is the closer choice when the documented procedure is that repair rather than vascularized graft transfer.
How does this differ from 25440?
Code 25440 addresses repair of a scaphoid nonunion. Use 25430 when the operative work specifically includes vascularized graft transfer to a carpal bone.
What documentation supports reporting 25430?
The operative report should identify the carpal bone and indication, describe transfer of the vascularized graft, and document any fixation performed.
Can modifier 50 be used for bilateral surgery?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
How are assistants and co-surgeons handled?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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