Billing code 25645: Carpal fracture repairMedicare rate & RVUs in Ohio
Report open treatment for a fractured carpal bone other than the scaphoid, with coding based on the bone treated and each bone counted separately.
CMS doesn’t publish an office rate for 25645 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 25645 covers
A hand or orthopedic surgeon surgically exposes a fractured carpal bone other than the scaphoid, restores its alignment, and may stabilize the fragments. The code can apply to bones such as the lunate, triquetrum, hamate, or capitate. These operations are generally performed in an operating room for a fracture requiring open treatment rather than closed care.
Select 25645 when the operative report supports open treatment of a non-scaphoid carpal fracture, and identify the bone and each bone treated. The 90-day global period includes 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 at 50%. 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.
25645 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $524.46 |
How the 25645 rate is calculated
Each of 25645’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 · 25645
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.23Practice expense 7.59Malpractice 1.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25645
25645 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25645
Carpal fracture repair
| 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 · 25645
Carpal fracture repair
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
25645 without 50 · national facility
$546.10
Carpal fracture repair
25645-50 · Bilateral: 150%
$819.15
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).
25645 compared with similar codes
Compare codes
25645 vs 25628 vs 25630 vs 25635 vs 25685: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25628Scaphoid fixation
- Both describe open carpal fracture treatment, but 25628 is for the scaphoid; 25645 is for another carpal bone.
- 25630Carpal fracture care
- 25630 describes closed treatment of a non-scaphoid carpal fracture without manipulation. Use 25645 when the fracture receives open treatment.
- 25635Carpal fracture treatment
- 25635 is closed treatment of a non-scaphoid carpal fracture with manipulation; 25645 describes open treatment.
- 25685Wrist fracture-dislocation
- 25685 addresses an open-treated trans-scaphoid perilunar fracture-dislocation, a combined fracture-dislocation pattern rather than an isolated non-scaphoid carpal fracture.
25645 billing questions
When should 25645 be used instead of 25628?
Use 25645 for open treatment of a carpal fracture other than the scaphoid. Use 25628 when the fractured bone is the scaphoid.
Does the code count each fractured bone?
Yes. The code is reported for each carpal bone treated, so documentation should identify the specific bone or bones addressed.
Is fracture fixation separately reported?
Reduction and stabilization performed as part of the open treatment are captured in the fracture service. Do not report a separate code for fixation of that same fracture.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can 25645 be reported for both wrists?
For bilateral treatment, CMS payment uses modifier 50 and pays the procedure at 150%. Document the treated bone or bones on each side.
Can an assistant surgeon be reported?
Assistant-at-surgery services may be paid for 25645. 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 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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