$339.99
Both cover closed treatment of a carpal fracture other than the scaphoid, but 25635 includes manipulation and 25630 does not.
On this page
CMS RVU26D · Effective 2026-10-01
25635 Carpal fracture treatment Medicare reimbursement rates in Wyoming
Reports closed manipulation to realign a fractured carpal bone other than the scaphoid, with separate reporting for each bone treated. Compare 25635 office and facility rates across CMS payment localities in Wyoming.
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 25635 in Wyoming?
Wyoming 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
$512.38
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$414.85
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 fracture care
About 25635: Closed treatment of other carpal fracture
Reports closed manipulation to realign a fractured carpal bone other than the scaphoid, with separate reporting for each bone treated.
An orthopedist, hand surgeon, or other qualified treating clinician reports this service when a carpal fracture other than a scaphoid fracture is treated without surgical exposure and requires manipulation to restore alignment. Examples of eligible bones include the triquetrum, lunate, capitate, hamate, trapezium, trapezoid, and pisiform. Treatment may occur in an emergency department, clinic, or other setting where the clinician provides fracture care.
Select the code for each bone treated and document the fracture site, laterality, closed approach, and the manipulation performed. A fracture treated without manipulation is reported with 25630; scaphoid fractures belong to their own code family. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25635
- 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 RVU4.49 · 29%
- Practice expense (office) RVU10.14 · 65%
- Malpractice RVU0.96 · 6%
90
Medicare services in 2024 · #4956 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.
25635 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 25645 when the other carpal fracture is treated through an open approach; 25635 describes closed treatment with manipulation.
$540.43
Code 25624 is for a scaphoid fracture treated with manipulation. Code 25635 is for another carpal bone.
$346.02
Code 25622 covers closed treatment of a scaphoid fracture without manipulation; 25635 covers manipulation of a different carpal bone.
Compare 25635 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
Wyoming** →
Office / nonfacility
$512.38
Facility
$414.85
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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 25635 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,495
- Code
- 25635
- Physician work
- 4.49
- Practice expense
- 10.14
- Malpractice
- 0.96
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.49 | × 1.000 | 4.4900 |
| Practice expense | 10.14 | × 1.000 | 10.1400 |
| Malpractice | 0.96 | × 0.740 | 0.7104 |
| Total RVUs | 15.3404 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$512.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.49 | 1 |
| Practice expense | 10.14 | 1 |
| Malpractice | 0.96 | 0.74 |
(4.49 × 1 + 10.14 × 1 + 0.96 × 0.74) × $33.4009 = $512.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.49 | 1 |
| Practice expense | 7.22 | 1 |
| Malpractice | 0.96 | 0.74 |
(4.49 × 1 + 7.22 × 1 + 0.96 × 0.74) × $33.4009 = $414.85
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.
25635 billing questions
How does this differ from 25630?
Use 25635 when closed treatment includes manipulation to realign the fracture. Code 25630 is for closed treatment without manipulation.
Can this code be used for a scaphoid fracture?
No. Scaphoid fractures are reported from the scaphoid-specific family, such as 25622 or 25624, depending on whether manipulation is performed.
How many units should be reported?
The code is reported for each carpal bone treated. Document the bone and the manipulation for each treated fracture.
What does the 90-day global include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
When the service is performed bilaterally, modifier 50 applies; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is available only with documentation of medical necessity. 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.
2,49225624,,Cltx carpl scphd fx w/mnpj,A,,4.65,10.79,,7.71,,1.00,16.44,13.36,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,49325628,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,