CPT code 25445: Trapezium arthroplasty, prosthetic replacement2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 25445 in California.

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

What 25445 covers

This service is an operative arthroplasty in which a prosthetic implant replaces the trapezium, the carpal bone at the base of the thumb. It is most often encountered in reconstruction for painful thumb carpometacarpal disease when the surgeon selects a trapezial prosthesis. An orthopedic hand surgeon typically performs the procedure in an operating room, such as in a hospital outpatient department or ambulatory surgery center.

Report the code when the operative record supports prosthetic replacement of the trapezium, rather than trapeziectomy with interposition or suspensionplasty. Documentation should identify the treated side, the operative indication, and the prosthetic replacement performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for bilateral surgery is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with 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 25445 pays more and less in California

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

29 of 29 payment localities

How the 25445 rate is calculated

Each of 25445’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 25445

25445 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

25445 compared with similar codes

How to choose

25447Interposition arthroplastyIntercarpal or carpometacarpal joints

Choose 25445 for prosthetic replacement of the trapezium. Choose 25447 when the surgeon performs interposition arthroplasty instead.

25448Wrist arthroplastyWith suspensionplasty

25448 represents suspensionplasty at intercarpal or carpometacarpal joints; 25445 is for prosthetic replacement of the trapezium.

25443Wrist arthroplastyDistal scaphoid and carpus

Both involve prosthetic replacement arthroplasty, but 25443 applies to the scaphoid and 25445 to the trapezium.

25446Wrist arthroplastyDistal radius and carpus

25446 covers prosthetic arthroplasty involving the distal radius and carpal bones; 25445 identifies trapezium replacement.

Codes related to 25445

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