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Billing code 25335: Wrist centralizationMedicare rate & RVUs

Reports surgical repositioning of a radially displaced wrist over the ulna, commonly to correct wrist alignment in congenital radial deficiency.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $874.77 for 25335 nationally in a facility.

Medicare rate · 25335

Wrist centralization

Swap in your local Medicare rate.

Work RVUs
13.06
Total RVUs
26.19
Global days
090

National rate · 2026

$874.77

Facility setting, before claim adjustments.

See every locality for 25335 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 25335 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 25335 covers

This operation repositions the carpus over the distal ulna to address radial-sided wrist displacement, most often in a patient with congenital radial longitudinal deficiency, sometimes called radial club hand. A pediatric orthopedic or hand surgeon performs the reconstruction in an operating room. The procedure may involve releasing contracted soft tissues and stabilizing the repositioned wrist, as needed to achieve the planned alignment.

Report 25335 when the operative objective is centralizing the wrist on the ulna; document the underlying deformity, side, structures addressed, and the repositioning and stabilization performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 25335 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

25335 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$791.36
Alaska*Unavailable$1,073.83
ArizonaUnavailable$850.72
ArkansasUnavailable$781.11
AtlantaUnavailable$900.21
AustinUnavailable$885.16
BakersfieldUnavailable$880.10
Baltimore/Surr. CntysUnavailable$928.94
BeaumontUnavailable$837.06
BrazoriaUnavailable$854.79

25335 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
25335 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 25335 rate is calculated

Each of 25335’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 · 25335

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.06Practice expense 10.36Malpractice 2.77

26.1900 adjusted RVUs×$33.4009 conversion factor=$874.77

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25335

25335 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25335

Wrist centralization

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)0Not permitted.
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 · 25335

Wrist centralization

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

25335 without 50 · national facility

$874.77

Wrist centralization

25335-50 · Bilateral: 150%

$1,312.16

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

25335 compared with similar codes

Compare codes

25335 vs 25320 vs 25332 vs 25337: national Medicare rates

Swap in your local Medicare rate.

  • 25335
    Wrist centralization · 13.06 wRVU
    —
  • 25320
    Wrist stabilization · 12.43 wRVU
    —
  • 25332
    Wrist arthroplasty · 11.45 wRVU
    —
  • 25337
    Joint reconstruction · 11.44 wRVU
    —

How to choose

25320Wrist stabilization
25335 centers the carpus over the ulna. 25320 is used for a wrist joint repair or revision when the surgeon is not performing that centralization.
25332Wrist arthroplasty
25335 corrects wrist position over the ulna. 25332 describes wrist joint arthroplasty, a different operation and objective.
25337Joint reconstruction
25335 repositions the carpus on the ulna; 25337 concerns reconstruction of the distal radioulnar joint.

Codes related to 25335

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

Codes related to 25335
CodeHow it relatesNational office range
Used instead
25320Wrist stabilizationA wrist joint repair or reconstruction may be reported when that, rather than carpal centralization, is performed.No office rate
25332Wrist arthroplastyWrist joint arthroplasty addresses a different operative objective from repositioning the carpus over the ulna.No office rate
25337Joint reconstructionConsider when the operation reconstructs the distal radioulnar joint rather than centralizing the wrist.No office rate

25335 billing questions

When is 25335 appropriate instead of a wrist joint repair code?

Use 25335 when the operative goal is to reposition the carpus over the ulna, typically for radial-sided wrist displacement. A wrist joint repair or reconstruction code describes a different operative objective.

Does the 90-day global include postoperative visits?

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

How is bilateral centralization reported?

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

Can another procedure be reported during the same session?

A distinct procedure may be subject to the standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50%. The operative record should support each service performed.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid for this procedure. Co-surgeons and team surgery are not permitted under the CMS rules provided.

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 25335PPRRVU2026_Oct_nonQPP.csv, line 2,436 (RVU26D)

Open CMS sourceHow we calculate rates

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