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Billing code 25443: Wrist arthroplastyMedicare rate & RVUs

Reports wrist arthroplasty using a prosthetic replacement for the distal scaphoid and carpus when that specific anatomy is surgically treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $737.49 for 25443 nationally in a facility.

Medicare rate · 25443

Wrist arthroplasty

Swap in your local Medicare rate.

Work RVUs
10.39
Total RVUs
22.08
Global days
090

National rate · 2026

$737.49

Facility setting, before claim adjustments.

See every locality for 25443 → · 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 25443 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 25443 covers

An orthopedic hand or wrist surgeon uses this code when performing arthroplasty with prosthetic replacement involving the distal scaphoid and carpus. The procedure is generally performed in an operating room for a patient whose affected wrist anatomy is being treated with an implant. The operative report should identify the structures replaced and document the prosthetic work performed.

Report the code for the documented distal scaphoid and carpal target, not for replacement of a different wrist bone or a broader joint reconstruction. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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 25443 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

25443 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$665.98
Alaska*Unavailable$898.62
ArizonaUnavailable$717.08
ArkansasUnavailable$657.16
AtlantaUnavailable$758.37
AustinUnavailable$748.19
BakersfieldUnavailable$745.78
Baltimore/Surr. CntysUnavailable$783.60
BeaumontUnavailable$703.75
BrazoriaUnavailable$721.25

25443 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
25443 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 25443 rate is calculated

Each of 25443’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 · 25443

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.39Practice expense 9.49Malpractice 2.20

22.0800 adjusted RVUs×$33.4009 conversion factor=$737.49

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

Payment rules and modifiers for 25443

25443 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25443

Wrist arthroplasty

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 · 25443

Wrist arthroplasty

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

25443 without 50 · national facility

$737.49

Wrist arthroplasty

25443-50 · Bilateral: 150%

$1,106.24

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

25443 compared with similar codes

Compare codes

25443 vs 25441 vs 25444 vs 25445 vs 25446: national Medicare rates

Swap in your local Medicare rate.

  • 25443
    Wrist arthroplasty · 10.39 wRVU
    —
  • 25441
    Wrist arthroplasty · 12.96 wRVU
    —
  • 25444
    Wrist arthroplasty · 11.13 wRVU
    —
  • 25445
    Trapezium arthroplasty · 9.63 wRVU
    —
  • 25446
    Wrist arthroplasty · 16.87 wRVU
    —

How to choose

25441Wrist arthroplasty
Use 25441 when the prosthetic replacement target is the distal radius. This code identifies the distal scaphoid and carpus instead.
25444Wrist arthroplasty
Use 25444 for prosthetic replacement of the lunate; this code concerns the distal scaphoid and carpus.
25445Trapezium arthroplasty
Use 25445 when the prosthetic replacement target is the trapezium, rather than the distal scaphoid and carpus.
25446Wrist arthroplasty
Use 25446 when the documented prosthetic arthroplasty involves the distal radius and carpus. This code identifies the distal scaphoid and carpus.

Codes related to 25443

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

Codes related to 25443
CodeHow it relatesNational office range
Same family
25441Wrist arthroplastyProsthetic arthroplasty targeting the distal radius rather than the distal scaphoid and carpus.No office rate
25442Ulna arthroplastyProsthetic arthroplasty targeting the distal ulna.No office rate
25444Wrist arthroplastyProsthetic arthroplasty targeting the lunate.No office rate
25445Trapezium arthroplastyProsthetic arthroplasty targeting the trapezium.No office rate
25446Wrist arthroplastyProsthetic arthroplasty involving the distal radius and carpus.No office rate

25443 billing questions

How do I distinguish this code from other wrist prosthetic arthroplasties?

Select it when the operative documentation identifies the distal scaphoid and carpus as the prosthetic replacement target. Codes for the distal radius, ulna, lunate, or trapezium identify different anatomy.

What documentation supports reporting this code?

The operative report should identify the distal scaphoid and carpal structures treated and describe the prosthetic replacement performed. Documentation of a different bone or reconstruction target points to a different code.

Does this code have a 90-day global period?

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

How is a bilateral procedure reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 25443PPRRVU2026_Oct_nonQPP.csv, line 2,460 (RVU26D)

Open CMS sourceHow we calculate rates

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