CPT code 25444: Wrist arthroplasty, prosthetic lunate2026 Medicare rate & RVUs in Texas
Reports wrist arthroplasty in which the surgeon replaces the lunate with a prosthesis, including selected cases of lunate collapse from Kienböck disease.
CMS doesn’t publish an office rate for 25444 in Texas.
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 25444 covers
An orthopedic or hand surgeon uses this code when performing wrist arthroplasty with a prosthetic lunate. A typical clinical setting is treatment of advanced lunate damage, such as collapse associated with Kienböck disease, when the operative plan calls for lunate replacement rather than removal alone or reconstruction of a different carpal bone. The service is generally performed in an operating room under anesthesia.
Select 25444 when the operative report supports prosthetic replacement of the lunate; document the condition treated, the bone replaced, and the implant procedure. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For procedures on both wrists, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; 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 25444 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $770.42 |
| Beaumont, TX | Unavailable | $726.00 |
| Brazoria, TX | Unavailable | $743.87 |
| Dallas, TX | Unavailable | $751.42 |
| Fort Worth, TX | Unavailable | $749.19 |
| Galveston, TX | Unavailable | $747.95 |
| Houston, TX | Unavailable | $787.30 |
| Rest of Texas | Unavailable | $736.46 |
How the 25444 rate is calculated
Each of 25444’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 · 25444
RVUs × geographic indexes × conversion factor
Work11.13
11.13 RVUs× 1.000 GPCI
Practice expense9.46
9.46 RVUs× 1.000 GPCI
Malpractice2.15
2.15 RVUs× 1.000 GPCI
Adjusted RVUs
22.7400
Conversion factor
$33.4009
Medicare rate
$759.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25444
25444 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25444
Wrist arthroplasty, prosthetic lunate
| 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 · 25444
Wrist arthroplasty, prosthetic lunate
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
25444 without 50 · national facility
$759.54
Wrist arthroplasty, prosthetic lunate
25444-50 · Bilateral: 150%
$1,139.31
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).
25444 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25443Wrist arthroplastyDistal scaphoid and carpus
- Choose 25444 for prosthetic replacement of the lunate; choose 25443 when the prosthetic arthroplasty involves the distal scaphoid.
- 25445Trapezium arthroplastyProsthetic replacement
- 25445 is for prosthetic arthroplasty involving the trapezium, not the lunate.
- 25215CarpectomyEntire proximal carpal row
- 25215 represents removal of the proximal row of carpal bones. It is distinct from replacing the lunate with a prosthesis under 25444.
25444 billing questions
When should 25444 be chosen over a lunate excision code?
Use 25444 when the surgeon performs arthroplasty with a prosthetic lunate. Removal of the lunate without prosthetic replacement is a different service.
How does 25444 differ from 25443?
25444 describes prosthetic replacement of the lunate; 25443 describes prosthetic arthroplasty involving the distal scaphoid. Follow the bone identified in the operative report.
Can 25444 be reported for both wrists?
For bilateral performance, CMS lists modifier 50 and payment at 150%. The operative documentation should support lunate prosthetic arthroplasty on each side.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.
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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