No office rate
Both address lunate dislocation, but 25690 is for closed manipulative reduction; 25695 is for open treatment.
On this page
CMS RVU26D · Effective 2026-10-01
25690 Lunate reduction Medicare reimbursement rates in Oklahoma
Reports closed manipulative reduction of a dislocated lunate, rather than open treatment or treatment of a wrist fracture-dislocation. Compare 25690 office and facility rates across CMS payment localities in Oklahoma.
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 25690 in Oklahoma?
Oklahoma 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
$445.99
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 25690: Closed lunate dislocation reduction
Reports closed manipulative reduction of a dislocated lunate, rather than open treatment or treatment of a wrist fracture-dislocation.
This service involves manipulating a dislocated lunate back into position without surgically exposing the joint. An orthopedic or hand surgeon may perform the reduction in an emergency department or surgical setting, often with anesthesia or sedation. The injury is a lunate dislocation, not simply a carpal fracture or a dislocation of the distal radioulnar joint.
Report the service when documentation supports a lunate dislocation and a closed reduction performed by manipulation. Record the affected wrist, reduction method, and relevant findings; distinguish an associated fracture-dislocation from an isolated lunate dislocation. The code has a 90-day global period, which 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 are subject to the standard 50% reduction. Modifier 50 identifies bilateral treatment and is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25690
- 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 RVU5.58 · 39%
- Practice expense (office) RVU7.66 · 53%
- Malpractice RVU1.20 · 8%
19
Medicare services in 2024 · #5936 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.
25690 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
Use 25680 for a trans-scaphoid perilunar fracture treated closed with manipulation, not an isolated lunate dislocation.
No office rate
This code addresses a radiocarpal or intercarpal dislocation involving one or more bones; 25690 is specific to lunate dislocation.
Compare 25690 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$445.99
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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 25690 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
2,507
- Code
- 25690
- Physician work
- 5.58
- Practice expense
- 7.66
- Malpractice
- 1.20
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.58 | × 1.000 | 5.5800 |
| Practice expense | 7.66 | × 0.893 | 6.8404 |
| Malpractice | 1.20 | × 0.777 | 0.9324 |
| Total RVUs | 13.3528 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$445.99
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.58 | 1 |
| Practice expense | 7.66 | 0.893 |
| Malpractice | 1.2 | 0.777 |
(5.58 × 1 + 7.66 × 0.893 + 1.2 × 0.777) × $33.4009 = $445.99
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.
25690 billing questions
When is this code used instead of open lunate treatment?
Use this code for a lunate dislocation reduced by closed manipulation. When the surgeon exposes the joint to treat the dislocation, consider 25695 instead.
Does this code describe treatment of a perilunate fracture-dislocation?
No. It describes closed manipulative reduction of a lunate dislocation. A trans-scaphoid perilunar fracture-dislocation is a different injury; code selection depends on the fracture pattern and treatment performed.
What documentation supports reporting the reduction?
Document the lunate dislocation, the affected wrist, and that the lunate was reduced by closed manipulation. Include relevant examination and imaging findings and the treatment performed.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are bilateral procedures and multiple procedures paid?
Modifier 50 identifies bilateral treatment and is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are reduced to 50%.
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.
2,50425676,,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
2,51025805,,Arthrd wrist w/sliding graft,A,,11.44,9.84,NA,9.84,,2.44,23.72,23.72,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193