CPT code 25445: Trapezium arthroplasty, prosthetic replacement2026 Medicare rate & RVUs in Missouri
Reports operative arthroplasty replacing the trapezium with a prosthesis, commonly selected for reconstruction of painful thumb-base joint disease.
CMS doesn’t publish an office rate for 25445 in Missouri.
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 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 Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $645.49 |
| Metropolitan St. Louis, MO | Unavailable | $650.68 |
| Rest of Missouri | Unavailable | $623.72 |
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.
How the rate is built · 25445
RVUs × geographic indexes × conversion factor
Work9.63
9.63 RVUs× 1.000 GPCI
Practice expense8.39
8.39 RVUs× 1.000 GPCI
Malpractice1.86
1.86 RVUs× 1.000 GPCI
Adjusted RVUs
19.8800
Conversion factor
$33.4009
Medicare rate
$664.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25445
25445 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25445
Trapezium arthroplasty, prosthetic replacement
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 25445
Trapezium arthroplasty, prosthetic replacement
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
25445 without 50 · national facility
$664.01
Trapezium arthroplasty, prosthetic replacement
25445-50 · Bilateral: 150%
$996.02
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).
25445 compared with similar codes
Compare codes · National
5 codes, side by side
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.
25445 billing questions
How does this differ from trapeziectomy with interposition?
Report 25445 when the surgeon replaces the trapezium with a prosthesis. Interposition arthroplasty is a different technique and is represented by 25447.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
How is bilateral surgery reported?
For bilateral procedures, modifier 50 applies; CMS pays the service at 150%.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
Can an assistant surgeon be paid for this procedure?
CMS applies a statutory restriction on assistant-at-surgery payment for this code. Co-surgeon payment is allowed only with supporting documentation.
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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