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CPT code 25448: Wrist arthroplasty, with suspensionplasty2026 Medicare rate & RVUs

Reports interposition arthroplasty with suspension for an intercarpal or carpometacarpal joint, commonly used to reconstruct the thumb base after painful arthritis.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $819.32 for 25448 nationally in a facility.

Medicare rate · 25448

Wrist arthroplasty, with suspensionplasty

Office or facility?

Work RVUs
11.55
Total RVUs
24.53
Global days
090

National rate · 2026

$819.32

Facility setting, before claim adjustments.

See every locality for 25448 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 25448 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 25448 covers

This procedure reconstructs an intercarpal or carpometacarpal joint using interposition and suspension techniques. A common setting is surgery for painful thumb carpometacarpal, or basal-joint, arthritis, where the surgeon removes the trapezium and stabilizes the first metacarpal. An orthopedic or hand surgeon typically performs the operation in a hospital or ambulatory surgery center. The suspension component distinguishes this service from interposition arthroplasty without that component.

Report the code when the operative work includes the specified joint reconstruction with suspension; the operative report should identify the treated joint 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. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery services may be paid; 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 25448 pays more and less

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

109 of 109 payment localities

25448 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$742.43
AlaskaUnavailable$1,002.62
ArizonaUnavailable$797.58
ArkansasUnavailable$732.92
Atlanta, GAUnavailable$841.01
Austin, TXUnavailable$832.60
Bakersfield, CAUnavailable$832.49
Baltimore area, MDUnavailable$869.20
Beaumont, TXUnavailable$781.70
Brazoria, TXUnavailable$803.00

25448 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
25448 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 25448 rate is calculated

Each of 25448’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 · 25448

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.55

11.55 RVUs× 1.000 GPCI

Practice expense10.78

10.78 RVUs× 1.000 GPCI

Malpractice2.20

2.20 RVUs× 1.000 GPCI

Adjusted RVUs

24.5300

Conversion factor

$33.4009

Medicare rate

$819.32

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 25448

25448 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25448

Wrist arthroplasty, with suspensionplasty

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25448

Wrist arthroplasty, with suspensionplasty

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25448 without 50 · national facility

$819.32

Wrist arthroplasty, with suspensionplasty

25448-50 · Bilateral: 150%

$1,228.98

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).

When to use modifier 50

25448 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 25448

    Wrist arthroplasty, with suspensionplasty11.55 wRVU

    Not priced

  • 25447

    Interposition arthroplasty, intercarpal or carpometacarpal joints10.24 wRVU

    Not priced

  • 25445

    Trapezium arthroplasty, prosthetic replacement9.63 wRVU

    Not priced

  • 25449

    Wrist revision, arthroplasty revision14.57 wRVU

    Not priced

How to choose

25447Interposition arthroplastyIntercarpal or carpometacarpal joints
Use 25448 when the interposition reconstruction includes suspension. Code 25447 describes the related interposition arthroplasty without suspension.
25445Trapezium arthroplastyProsthetic replacement
This code describes prosthetic replacement of the trapezium, rather than interposition arthroplasty with suspension.
25449Wrist revisionArthroplasty revision
This code is for revision of a wrist arthroplasty, not primary intercarpal or carpometacarpal reconstruction with suspension.

Codes related to 25448

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 25448
CodeHow it relatesNational office range
Same family
25447Interposition arthroplasty, intercarpal or carpometacarpal jointsRelated interposition arthroplasty without the suspension component.No office rate
Used instead
25445Trapezium arthroplasty, prosthetic replacementProsthetic replacement of the trapezium is a different approach to thumb-base joint reconstruction.No office rate
25449Wrist revision, arthroplasty revisionRevision wrist arthroplasty applies when an existing wrist arthroplasty is revised.No office rate

25448 billing questions

How does 25448 differ from 25447?

25448 describes interposition arthroplasty with suspension. Use 25447 for the related interposition arthroplasty without the suspension component.

What documentation supports reporting 25448?

The operative report should identify the intercarpal or carpometacarpal joint treated and describe both the interposition reconstruction and suspension work.

Does the 90-day global period include routine postoperative care?

Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation.

How is bilateral 25448 handled?

For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.

Can 25448 be reported with another procedure performed in the same session?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.

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
RVUs for 25448PPRRVU2026_Oct_nonQPP.csv, line 2,465 (RVU26D)

Open CMS sourceHow we calculate rates

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