CPT code 25447: Interposition arthroplasty, intercarpal or carpometacarpal joints2026 Medicare rate & RVUs in Michigan
Reports interposition arthroplasty of an intercarpal or carpometacarpal joint, commonly used to treat painful thumb-base arthritis with reconstruction.
CMS doesn’t publish an office rate for 25447 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 25447 covers
This code describes reconstruction of an intercarpal or carpometacarpal joint using an interposed tissue or other reconstructive material. A common application is surgery for painful thumb carpometacarpal osteoarthritis, often involving trapeziectomy and tendon interposition, including ligament reconstruction and tendon interposition techniques. Orthopedic or hand surgeons typically perform the procedure in an operating room, often in a hospital outpatient department or ambulatory surgery center.
Select the code when the operative service is an interposition arthroplasty, rather than prosthetic replacement or a suspensionplasty technique. The operative report should identify the joint treated and describe the reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 25447 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $776.98 |
| Rest of Michigan | Unavailable | $723.02 |
How the 25447 rate is calculated
Each of 25447’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 · 25447
RVUs × geographic indexes × conversion factor
Work10.24
10.24 RVUs× 1.000 GPCI
Practice expense10.07
10.07 RVUs× 1.000 GPCI
Malpractice1.96
1.96 RVUs× 1.000 GPCI
Adjusted RVUs
22.2700
Conversion factor
$33.4009
Medicare rate
$743.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25447
25447 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25447
Interposition arthroplasty, intercarpal or carpometacarpal joints
| 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 · 25447
Interposition arthroplasty, intercarpal or carpometacarpal joints
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
25447 without 50 · national facility
$743.84
Interposition arthroplasty, intercarpal or carpometacarpal joints
25447-50 · Bilateral: 150%
$1,115.76
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).
25447 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25448Wrist arthroplastyWith suspensionplasty
- Choose 25447 for interposition arthroplasty; choose 25448 when the documented reconstruction is a suspensionplasty.
- 25445Trapezium arthroplastyProsthetic replacement
- 25445 identifies prosthetic trapezium replacement. 25447 represents interposition arthroplasty without that prosthetic replacement approach.
- 25449Wrist revisionArthroplasty revision
- 25449 is for revision wrist arthroplasty. 25447 describes interposition arthroplasty, not revision of a prior wrist replacement.
25447 billing questions
How is 25447 distinguished from 25448?
25447 describes interposition arthroplasty. 25448 is the distinct suspensionplasty technique, so follow the operative method rather than treating the codes as interchangeable.
When would 25445 be a better fit?
Use 25445 when the surgeon performs arthroplasty with a prosthetic trapezium. Code 25447 describes interposition reconstruction rather than prosthetic replacement.
What documentation supports reporting 25447?
Document the intercarpal or carpometacarpal joint treated and the interposition reconstruction performed. For thumb-base surgery, the operative report should make clear that the service is an interposition arthroplasty.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are bilateral procedures and multiple procedures paid?
Bilateral reporting with modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be paid for 25447?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
Fee sheets
Put 25447 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet