No office rate
Both describe open carpal fracture treatment, but 25628 is for the scaphoid; 25645 is for another carpal bone.
On this page
CMS RVU26D · Effective 2026-10-01
25645 Carpal fracture repair Medicare reimbursement rates in Texas
Report open treatment for a fractured carpal bone other than the scaphoid, with coding based on the bone treated and each bone counted separately. Compare 25645 office and facility rates across CMS payment localities in Texas.
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 25645 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 25645 pays more and less in Texas
Surgical orthopedics
About 25645: Open treatment of other carpal fracture
Report open treatment for a fractured carpal bone other than the scaphoid, with coding based on the bone treated and each bone counted separately.
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.
CMS billing rules for 25645
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.23 · 44%
- Practice expense (office) RVU7.59 · 46%
- Malpractice RVU1.53 · 9%
111
Medicare services in 2024 · #4791 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.
25645 compared with similar codes
Office rates for Texas, from the same CMS release.
$323.21–$356.19
25630 describes closed treatment of a non-scaphoid carpal fracture without manipulation. Use 25645 when the fracture receives open treatment.
$487.96–$537.01
25635 is closed treatment of a non-scaphoid carpal fracture with manipulation; 25645 describes open treatment.
No office rate
25685 addresses an open-treated trans-scaphoid perilunar fracture-dislocation, a combined fracture-dislocation pattern rather than an isolated non-scaphoid carpal fracture.
Compare 25645 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $555.47 |
| Beaumont | Office Unavailable | Facility $519.66 |
| Brazoria | Office Unavailable | Facility $534.51 |
| Dallas | Office Unavailable | Facility $540.01 |
| Fort Worth | Office Unavailable | Facility $538.14 |
| Galveston | Office Unavailable | Facility $537.47 |
| Houston | Office Unavailable | Facility $565.48 |
| Rest Of Texas | Office Unavailable | Facility $528.22 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
2,49325628,,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
2,49525635,,Cltx carpl fx w/mnpj ea b1,A,,4.49,10.14,,7.22,,0.96,15.59,12.67,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49625645,,Optx crpl fx oth/thn scph ea,A,,7.23,7.59,NA,7.59,,1.53,16.35,16.35,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49725650,,Cltx ulnar styloid fracture,A,,3.15,7.54,,5.92,,0.66,11.35,9.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49825651,,Perq skel fix ulnar styld fx,A,,5.67,7.38,NA,7.38,,1.13,14.18,14.18,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49925652,,Optx ulnar styloid fracture,A,,7.86,8.26,NA,8.26,,1.57,17.69,17.69,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00