CPT code 25246: Wrist injection, arthrography2026 Medicare rate & RVUs in Guam
Reports injection of contrast into a wrist joint to prepare for arthrographic imaging, such as evaluation of suspected ligament or triangular fibrocartilage injury.
Medicare pays $204.37 for 25246 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 25246 covers
A clinician injects contrast into the wrist joint to prepare for arthrographic imaging. This is commonly performed by a radiologist or an orthopedic specialist when evaluation of internal wrist structures, such as the triangular fibrocartilage complex or intrinsic ligaments, is needed. The study may be followed by radiographic, CT, or MR imaging, depending on the diagnostic question and the ordered examination.
Select this code for the wrist-joint injection, not for imaging alone or an injection into another joint. Documentation should identify the wrist treated, the injection and contrast used, and the clinical reason for the arthrogram; report the imaging service separately when performed and supported. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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.
25246 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $204.37 | $60.82 |
How the 25246 rate is calculated
Each of 25246’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 · 25246
RVUs × geographic indexes × conversion factor
Work1.41
1.41 RVUs× 1.000 GPCI
Practice expense4.07
4.07 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
5.6200
Conversion factor
$33.4009
Medicare rate
$187.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25246
The CMS indicators that decide how 25246 is paid alongside other services.
CMS payment indicators · 25246
Wrist injection, arthrography
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25246 without 50 · national office
$187.71
Wrist injection, arthrography
25246-50 · Bilateral: 150%
$281.57
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).
25246 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 73115Contrast wrist studyRadiographic arthrography
- 25246 is the wrist-joint contrast injection; 73115 reports the wrist arthrography imaging examination and its radiological supervision and interpretation.
- 24220Arthrographic injectionElbow joint
- Both codes describe arthrography injections, but 24220 is for the elbow and 25246 is for the wrist.
- 23350Shoulder injectionFor diagnostic imaging
- 23350 is the shoulder arthrography injection code. Use 25246 when the joint injected is the wrist.
25246 billing questions
How is this different from the wrist arthrography imaging code?
25246 represents the contrast injection into the wrist joint. The imaging examination and its interpretation are reported with the applicable imaging code when performed and documented.
Can 25246 be reported for an MR arthrogram?
Yes, when contrast is injected directly into the wrist joint to prepare for the MR examination. An MRI using only intravenous contrast is not a wrist arthrography injection.
What documentation supports reporting the injection?
Record the wrist and joint injected, the contrast administration, and the clinical reason for arthrographic evaluation. The imaging report should identify the examination performed.
How should bilateral wrist injections be reported?
CMS recognizes bilateral reporting with modifier 50 and pays it at 150%. The record should support injection of both wrists during the service.
Is same-day care included in this service?
Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. 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
Fee sheets
Put 25246 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet