Billing code 25440: Scaphoid repairMedicare rate & RVUs in Texas
Repair a scaphoid fracture nonunion, typically with bone grafting and fixation, when an orthopedic surgeon reconstructs the unhealed carpal bone.
CMS doesn’t publish an office rate for 25440 in Texas.
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 25440 covers
This service repairs a scaphoid fracture that has failed to unite. An orthopedic or hand surgeon may prepare the nonunion site and stabilize the scaphoid; bone grafting may be part of the reconstruction. It is generally performed in an operating room for a patient with persistent symptoms or impaired wrist function after a scaphoid fracture. The operative report should identify the scaphoid and document the nonunion repair and techniques used.
Report the code for repair of a scaphoid nonunion; internal fixation or graft use does not by itself change the selection to a repair code for another carpal bone. The 90-day global period includes 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% reduction. For a bilateral procedure reported with modifier 50, CMS pays 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is 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.
Where 25440 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $714.67 |
| Beaumont | Unavailable | $673.89 |
| Brazoria | Unavailable | $690.23 |
| Dallas | Unavailable | $697.24 |
| Fort Worth | Unavailable | $695.21 |
| Galveston | Unavailable | $694.02 |
| Houston | Unavailable | $730.63 |
| Rest Of Texas | Unavailable | $683.48 |
How the 25440 rate is calculated
Each of 25440’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 · 25440
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.41Practice expense 8.69Malpractice 2.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25440
25440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25440
Scaphoid 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) | 1 | Permitted with supporting documentation. |
| 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 · 25440
Scaphoid 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
25440 without 50 · national facility
$704.76
Scaphoid repair
25440-50 · Bilateral: 150%
$1,057.14
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).
25440 compared with similar codes
Compare codes
25440 vs 25431 vs 25430 vs 25400: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25431Carpal bone repair
- Choose 25440 for a scaphoid nonunion. Code 25431 applies to nonunion repair of another carpal bone.
- 25430Carpal bone graft
- This code reports repair of a scaphoid nonunion. Code 25430 describes a vascularized bone-graft procedure for a carpal bone.
- 25400Forearm bone repair
- This code treats a scaphoid nonunion; 25400 treats nonunion or malunion of the radius or ulna.
25440 billing questions
How is this code distinguished from 25431?
This code is for repair of a scaphoid nonunion. Code 25431 is for nonunion repair of another carpal bone.
Does the use of fixation change code selection?
No. Select this code based on repair of the scaphoid nonunion; fixation may be used as part of that repair.
Should bone graft use be documented?
Yes. The operative report should describe whether grafting was performed and the repair technique, along with the scaphoid nonunion being treated.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the other procedures.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is 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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