Billing code 25695: Lunate dislocationMedicare rate & RVUs in Utah
Reports open surgical reduction of a displaced lunate, with stabilization when needed, rather than closed treatment of the wrist injury.
CMS doesn’t publish an office rate for 25695 in Utah.
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 25695 covers
This service covers open surgery to restore a dislocated lunate to its position in the wrist. An orthopedic or hand surgeon typically performs it in an operating room for an acute traumatic injury, often after high-energy trauma. The surgeon exposes the joint, repositions the lunate, and may stabilize it with fixation when needed. The operative report should identify the dislocation and describe the open treatment performed.
Choose this code for open treatment of the lunate itself; closed treatment with manipulation is represented by 25690. A trans-scaphoid perilunate fracture-dislocation is a different injury pattern. 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 others at 50%. Modifier 50 reports bilateral treatment and is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require 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.
25695 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $578.99 |
How the 25695 rate is calculated
Each of 25695’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 · 25695
RVUs × geographic indexes × conversion factor
Work8.30
8.30 RVUs× 1.000 GPCI
Practice expense7.93
7.93 RVUs× 1.000 GPCI
Malpractice1.76
1.76 RVUs× 1.000 GPCI
Adjusted RVUs
17.9900
Conversion factor
$33.4009
Medicare rate
$600.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25695
25695 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25695
Lunate dislocation
| 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 · 25695
Lunate dislocation
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
25695 without 50 · national facility
$600.88
Lunate dislocation
25695-50 · Bilateral: 150%
$901.32
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).
25695 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25690Lunate reduction
- Use 25690 for closed treatment with manipulation of a lunate dislocation. Use 25695 when the surgeon treats the dislocation through an open approach.
- 25670Carpal dislocation repair
- This code addresses open treatment of radiocarpal or intercarpal dislocations more generally. Code 25695 identifies open treatment of a lunate dislocation.
- 25685Wrist fracture-dislocation
- Use 25685 for the trans-scaphoid perilunate fracture-dislocation pattern; 25695 is for open treatment of a lunate dislocation.
25695 billing questions
How does this differ from 25690?
25695 is for open surgical treatment of the lunate dislocation. Code 25690 is for closed treatment with manipulation.
Does this code include fixation?
Stabilization or internal fixation may be part of the open treatment when performed. The operative note should describe the reduction and any fixation used.
Should this be reported for a trans-scaphoid perilunate fracture-dislocation?
That fracture-dislocation pattern is distinct from an isolated lunate dislocation; consider 25685 when the documented injury and treatment match that code.
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 bilateral procedures and multiple same-session procedures paid?
Modifier 50 reports bilateral treatment and is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons require 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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