CPT code 25442: Ulna arthroplasty, prosthetic distal ulna2026 Medicare rate & RVUs

Medicare pays $740.50 for 25442 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 25442 covers

An orthopedic or hand surgeon replaces the distal end of the ulna with a prosthesis to address painful dysfunction or instability at the distal radioulnar joint. The procedure may be considered when disease or prior treatment has damaged the joint, including after distal ulna resection. It is generally performed in an operative facility, with the implant intended to restore support and function at the ulnar side of the wrist.

Select this code when the operative service includes prosthetic replacement of the distal ulna; the specific structure replaced, not just a diagnosis such as wrist arthritis, distinguishes it from nearby prosthetic arthroplasty codes. The operative report should identify the side, the distal ulna as the replaced structure, and the prosthesis placement. CMS assigns 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%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is 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 25442 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

25442 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 25442 rate is calculated

Each of 25442’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.

Payment rules and modifiers for 25442

25442 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

25442 compared with similar codes

How to choose

25441Wrist arthroplastyDistal radius prosthesis

Use 25442 when the prosthesis replaces the distal ulna; use 25441 when it replaces the distal radius.

25446Wrist arthroplastyDistal radius and carpus

Code 25446 describes prosthetic arthroplasty involving the distal radius and carpal bones, rather than replacement limited to the distal ulna.

25449Wrist revisionArthroplasty revision

Code 25449 describes revision of wrist arthroplasty. Code 25442 is for prosthetic replacement of the distal ulna, not revision of a prior wrist arthroplasty.

Codes related to 25442

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates