Summary & Overview
CPT 25635: Closed Manipulation of Carpal Bone Fracture
CPT code 25635 denotes closed manipulation, without internal fixation, of a fractured carpal bone (excluding the scaphoid). It covers nonoperative realignment procedures commonly performed in acute wrist injuries where manual manipulation achieves acceptable alignment. This code is relevant nationally because wrist fractures are a common source of emergency and outpatient orthopedic care and because correct coding affects clinical documentation, procedural tracking, and payer adjudication.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, the typical sites of service where the code is billed, and a framework for understanding how this code fits into service lines for emergency and orthopedic care. The publication provides benchmarks and policy-oriented information relevant to billing and claims processing, coding relationships to related fracture management services, and common modifiers used in practice.
Data not available in the input for specific associated taxonomies, ICD-10 diagnosis codes, payer-specific coverage rules, and related codes is noted where applicable.
Billing Code Overview
CPT code 25635 describes closed treatment, manipulation only, of a fracture of one of the carpal bones of the wrist (excluding the scaphoid). This procedure involves nonoperative realignment of a fractured carpal bone without incision, typically performed using manual manipulation techniques.
-
Service type: Closed manipulation of a carpal bone fracture
-
Typical site of service: Emergency department, urgent care clinic, or outpatient orthopedic clinic depending on acuity and clinical stability
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to the emergency department after a ground-level fall onto an outstretched hand. The patient reports immediate wrist pain, swelling, and limited range of motion. Plain radiographs of the wrist reveal a displaced fracture of a carpal bone other than the scaphoid (for example, a lunate or triquetrum fracture) without open wound or neurovascular compromise. The orthopedic or hand surgery provider performs a closed reduction under local or conscious sedation in the ED or procedure room, confirming alignment with post-reduction radiographs, then applies a short arm cast or splint. The clinical workflow includes initial triage, radiographic imaging, informed consent, sedation/analgesia as needed, manipulation/closed reduction using manual techniques, post-procedure imaging to document alignment, cast or splint application, discharge instructions, and scheduled follow-up for repeat imaging and possible escalation to operative fixation if reduction is unstable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure performed at an unlisted or unspecified location (payer-specific) | Rarely used; include only if payer requires when place-of-service is atypical (check payer policy). |
11 |