CPT code 25335: Wrist centralization, carpus positioned over ulna2026 Medicare rate & RVUs in Michigan
Reports surgical repositioning of a radially displaced wrist over the ulna, commonly to correct wrist alignment in congenital radial deficiency.
CMS doesn’t publish an office rate for 25335 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 25335 covers
This operation repositions the carpus over the distal ulna to address radial-sided wrist displacement, most often in a patient with congenital radial longitudinal deficiency, sometimes called radial club hand. A pediatric orthopedic or hand surgeon performs the reconstruction in an operating room. The procedure may involve releasing contracted soft tissues and stabilizing the repositioned wrist, as needed to achieve the planned alignment.
Report 25335 when the operative objective is centralizing the wrist on the ulna; document the underlying deformity, side, structures addressed, and the repositioning and stabilization performed. The code has a 90-day global period, including 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%. An assistant at surgery may be paid; 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 25335 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $926.13 |
| Rest of Michigan | Unavailable | $856.60 |
How the 25335 rate is calculated
Each of 25335’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 · 25335
RVUs × geographic indexes × conversion factor
Work13.06
13.06 RVUs× 1.000 GPCI
Practice expense10.36
10.36 RVUs× 1.000 GPCI
Malpractice2.77
2.77 RVUs× 1.000 GPCI
Adjusted RVUs
26.1900
Conversion factor
$33.4009
Medicare rate
$874.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25335
25335 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25335
Wrist centralization, carpus positioned over ulna
| 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) | 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 · 25335
Wrist centralization, carpus positioned over ulna
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
25335 without 50 · national facility
$874.77
Wrist centralization, carpus positioned over ulna
25335-50 · Bilateral: 150%
$1,312.16
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).
25335 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25320Wrist stabilizationCarpal instability
- 25335 centers the carpus over the ulna. 25320 is used for a wrist joint repair or revision when the surgeon is not performing that centralization.
- 25332Wrist arthroplastyWith or without interposition
- 25335 corrects wrist position over the ulna. 25332 describes wrist joint arthroplasty, a different operation and objective.
- 25337Joint reconstructionDistal radioulnar joint
- 25335 repositions the carpus on the ulna; 25337 concerns reconstruction of the distal radioulnar joint.
25335 billing questions
When is 25335 appropriate instead of a wrist joint repair code?
Use 25335 when the operative goal is to reposition the carpus over the ulna, typically for radial-sided wrist displacement. A wrist joint repair or reconstruction code describes a different operative objective.
Does the 90-day global include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral centralization reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Can another procedure be reported during the same session?
A distinct procedure may be subject to the standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50%. The operative record should support each service performed.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid for this procedure. 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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