Billing code 25680: Wrist fracture careMedicare rate & RVUs in Washington
Reports closed reduction by manipulation of a perilunate wrist fracture-dislocation that passes through the scaphoid, with related fracture care included in the global period.
CMS doesn’t publish an office rate for 25680 in Washington.
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 25680 covers
This service treats a carpal fracture-dislocation in which the scaphoid is fractured and the carpal bones are displaced around the lunate. The physician manipulates the wrist to restore alignment without surgically exposing the fracture, then immobilizes it. Orthopedic and hand surgeons commonly perform the reduction in a hospital or other procedural setting, often with imaging guidance.
Report this code when the documented injury pattern is a trans-scaphoid perilunate fracture-dislocation and the physician performs closed treatment with manipulation. The record should identify the fracture-dislocation, side, reduction performed, and resulting alignment; imaging and the treatment plan support the service. This major surgery code has a 90-day global period that 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 multiple-procedure reduction. Modifier 50 applies to bilateral performance, with payment at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
Where 25680 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $525.77 |
| Seattle (King Cnty) | Unavailable | $583.19 |
How the 25680 rate is calculated
Each of 25680’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 · 25680
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.07Practice expense 8.17Malpractice 1.30
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25680
25680 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25680
Wrist fracture care
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 25680
Wrist fracture care
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
25680 without 50 · national facility
$519.05
Wrist fracture care
25680-50 · Bilateral: 150%
$778.58
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).
25680 compared with similar codes
Compare codes
25680 vs 25685 vs 25624 vs 25690: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25685Wrist fracture-dislocation
- Use 25680 for closed reduction by manipulation of the trans-scaphoid perilunate fracture-dislocation; use 25685 when the injury is treated through an open approach.
- 25624Scaphoid fracture care
- Code 25624 is for a scaphoid fracture treated closed with manipulation, without the perilunate fracture-dislocation pattern.
- 25690Lunate reduction
- Code 25690 addresses a lunate dislocation treated closed with manipulation. Code 25680 requires the associated scaphoid fracture and perilunate injury pattern.
25680 billing questions
How is this different from code 25685?
Code 25680 is for closed treatment with manipulation. Code 25685 is for open treatment of the trans-scaphoid perilunate fracture-dislocation.
Can this code be used for an isolated scaphoid fracture?
No. It describes the combined fracture-dislocation pattern involving the scaphoid and perilunate alignment. An isolated scaphoid fracture may fit a different treatment code, such as 25624 when closed treatment with manipulation is performed.
Is the reduction reported separately from the fracture treatment?
The manipulation is part of the closed fracture-dislocation treatment represented by this code. Related postoperative care falls within its 90-day global period.
What documentation supports reporting this code?
Document the trans-scaphoid perilunate fracture-dislocation, the affected side, the closed manipulation performed, and the reduction result. Imaging and the immobilization and follow-up plan can support the record.
How are bilateral cases and multiple procedures handled?
For bilateral performance, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
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 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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