$518.02
Both codes address closed treatment of a scaphoid fracture. Report 25622 when treatment does not include manipulation; report 25624 when manipulation is performed.
On this page
CMS RVU26D · Effective 2026-10-01
25622 Scaphoid fracture care Medicare reimbursement rates in Ohio
Closed treatment of a scaphoid fracture without manipulation, typically using immobilization and follow-up for a wrist fracture managed nonoperatively. Compare 25622 office and facility rates across CMS payment localities in Ohio.
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 25622 in Ohio?
Ohio 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
$329.82
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$279.80
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Orthopedic surgery
About 25622: Closed scaphoid fracture treatment without manipulation
Closed treatment of a scaphoid fracture without manipulation, typically using immobilization and follow-up for a wrist fracture managed nonoperatively.
An orthopedic or hand surgeon reports this service when treating a carpal scaphoid (navicular) fracture nonoperatively without manipulating the fracture. The treatment commonly includes immobilizing the wrist, often in a thumb-spica cast or splint, and monitoring healing. It may be furnished in an office or a facility after clinical assessment and imaging establish the fracture and the treatment plan.
Select this code when the provider performs closed fracture treatment without a reduction maneuver; document the affected wrist, scaphoid fracture, treatment decision, and immobilization plan. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral treatment with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 25622
- 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 RVU2.72 · 26%
- Practice expense (office) RVU7.24 · 69%
- Malpractice RVU0.54 · 5%
1.3K
Medicare services in 2024 · #2750 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.
25622 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
25628 is for open reduction and internal fixation of a scaphoid fracture. 25622 is for closed treatment without manipulation.
$325.43
25630 applies to a carpal fracture other than the scaphoid treated without manipulation. 25622 identifies the scaphoid specifically.
Compare 25622 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
Ohio →
Office / nonfacility
$329.82
Facility
$279.80
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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 25622 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,491
- Code
- 25622
- Physician work
- 2.72
- Practice expense
- 7.24
- Malpractice
- 0.54
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.72 | × 1.000 | 2.7200 |
| Practice expense | 7.24 | × 0.913 | 6.6101 |
| Malpractice | 0.54 | × 1.008 | 0.5443 |
| Total RVUs | 9.8744 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$329.82
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.72 | 1 |
| Practice expense | 7.24 | 0.913 |
| Malpractice | 0.54 | 1.008 |
(2.72 × 1 + 7.24 × 0.913 + 0.54 × 1.008) × $33.4009 = $329.82
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.72 | 1 |
| Practice expense | 5.6 | 0.913 |
| Malpractice | 0.54 | 1.008 |
(2.72 × 1 + 5.6 × 0.913 + 0.54 × 1.008) × $33.4009 = $279.80
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.
25622 billing questions
When should 25622 be selected instead of 25624?
Use 25622 when the scaphoid fracture is treated without manipulation. Use 25624 when the provider performs manipulation as part of closed treatment.
How does 25622 differ from 25628?
25622 represents closed treatment without manipulation. Choose 25628 when the scaphoid fracture is treated with open reduction and internal fixation.
Can routine fracture follow-up be billed separately?
Related care during the 90-day global period is included, including routine follow-up for this fracture treatment. A separately identifiable service unrelated to the fracture requires its own support.
What documentation supports reporting 25622?
Document the scaphoid fracture, the affected wrist, the decision for closed treatment, and that treatment did not include manipulation. Include the immobilization and follow-up plan.
How is bilateral treatment handled?
For bilateral treatment reported with modifier 50, CMS pays 150% under the stated bilateral rule. Document treatment of both wrists.
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.
2,48825607,,Optx dst rd xartc fx/epi sep,A,,9.32,9.68,NA,9.68,,1.88,20.88,20.88,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,48925608,,Optx dst rd xart fx/epi sep2,A,,10.79,10.15,NA,10.15,,2.17,23.11,23.11,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49025609,,Optx dst rd xart fx/ep sep3+,A,,14.02,12.22,NA,12.22,,2.75,28.99,28.99,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49125622,,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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703