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Billing code 25447: Interposition arthroplastyMedicare rate & RVUs

Reports interposition arthroplasty of an intercarpal or carpometacarpal joint, commonly used to treat painful thumb-base arthritis with reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities39.4K Medicare services in 2024

Medicare pays $743.84 for 25447 nationally in a facility.

Medicare rate · 25447

Interposition arthroplasty

Swap in your local Medicare rate.

Work RVUs
10.24
Total RVUs
22.27
Global days
090

National rate · 2026

$743.84

Facility setting, before claim adjustments.

See every locality for 25447 → · 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 25447 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 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

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

109 of 109 payment localities

25447 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$673.38
Alaska*Unavailable$907.32
ArizonaUnavailable$723.98
ArkansasUnavailable$664.66
AtlantaUnavailable$763.40
AustinUnavailable$756.57
BakersfieldUnavailable$757.03
Baltimore/Surr. CntysUnavailable$789.38
BeaumontUnavailable$708.92
BrazoriaUnavailable$729.14

25447 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
25447 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 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

Swap in your local Medicare rate.

Work 10.24Practice expense 10.07Malpractice 1.96

22.2700 adjusted RVUs×$33.4009 conversion factor=$743.84

All indexes start 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

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 · 25447

Interposition 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

25447 without 50 · national facility

$743.84

Interposition arthroplasty

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).

When to use modifier 50

25447 compared with similar codes

Compare codes

25447 vs 25448 vs 25445 vs 25449: national Medicare rates

Swap in your local Medicare rate.

  • 25447
    Interposition arthroplasty · 10.24 wRVU
    —
  • 25448
    Wrist arthroplasty · 11.55 wRVU
    —
  • 25445
    Trapezium arthroplasty · 9.63 wRVU
    —
  • 25449
    Wrist revision · 14.57 wRVU
    —

How to choose

25448Wrist arthroplasty
Choose 25447 for interposition arthroplasty; choose 25448 when the documented reconstruction is a suspensionplasty.
25445Trapezium arthroplasty
25445 identifies prosthetic trapezium replacement. 25447 represents interposition arthroplasty without that prosthetic replacement approach.
25449Wrist revision
25449 is for revision wrist arthroplasty. 25447 describes interposition arthroplasty, not revision of a prior wrist replacement.

Codes related to 25447

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

Codes related to 25447
CodeHow it relatesNational office range
Same family
25448Wrist arthroplastyRelated intercarpal or carpometacarpal arthroplasty code for the suspensionplasty technique.No office rate
Used instead
25445Trapezium arthroplastyThumb-base arthroplasty using prosthetic trapezium replacement rather than interposition.No office rate
25446Wrist arthroplastyProsthetic arthroplasty involving the distal radius and carpal bones, rather than interposition reconstruction.No office rate

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
RVUs for 25447PPRRVU2026_Oct_nonQPP.csv, line 2,464 (RVU26D)

Open CMS sourceHow we calculate rates

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