CPT code 25442: Ulna arthroplasty, prosthetic distal ulna2026 Medicare rate & RVUs in Florida
Reports surgical replacement of the distal ulna with a prosthesis to address painful dysfunction of the distal radioulnar joint.
CMS doesn’t publish an office rate for 25442 in Florida.
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 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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $799.85 |
| Miami, FL | Unavailable | $857.90 |
| Rest of Florida | Unavailable | $761.30 |
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.
How the rate is built · 25442
RVUs × geographic indexes × conversion factor
Work10.84
10.84 RVUs× 1.000 GPCI
Practice expense9.28
9.28 RVUs× 1.000 GPCI
Malpractice2.05
2.05 RVUs× 1.000 GPCI
Adjusted RVUs
22.1700
Conversion factor
$33.4009
Medicare rate
$740.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25442
25442 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25442
Ulna arthroplasty, prosthetic distal 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) | 1 | Permitted with supporting documentation. |
| 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 · 25442
Ulna arthroplasty, prosthetic distal 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
25442 without 50 · national facility
$740.50
Ulna arthroplasty, prosthetic distal ulna
25442-50 · Bilateral: 150%
$1,110.75
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).
25442 compared with similar codes
Compare codes · National
4 codes, side by side
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.
25442 billing questions
How does this differ from 25441?
Code 25442 is for prosthetic replacement of the distal ulna. Code 25441 is for prosthetic replacement of the distal radius.
What should the operative report document?
Document the side, the distal ulna as the replaced structure, and placement of the prosthesis. The report should support that the service was replacement rather than repair or another wrist arthroplasty.
Are related postoperative visits included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For bilateral distal ulna prosthetic arthroplasty, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedures at 50%.
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
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