Billing code 25040: Wrist arthrotomyMedicare rate & RVUs in Delaware
A surgeon opens the radiocarpal or midcarpal wrist joint to explore it, drain it, or remove an intra-articular foreign body.
CMS doesn’t publish an office rate for 25040 in Delaware.
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 9 sections
What 25040 covers
This open wrist procedure accesses the radiocarpal or midcarpal joint for direct inspection, drainage, or removal of a foreign body within the joint. Orthopedic and hand surgeons may perform it when a joint infection requires operative drainage or when an intra-articular problem calls for direct exploration. The operative report should identify the joint entered and the reason for opening it, such as drainage or foreign-body removal.
Report the code when the service includes arthrotomy of the radiocarpal or midcarpal joint for one of these purposes; a wrist capsular incision for another purpose is not interchangeable. The 90-day global period includes 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 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
25040 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $518.27 |
How the 25040 rate is calculated
Each of 25040’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 · 25040
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.31Practice expense 6.95Malpractice 1.45
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25040
25040 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25040
Wrist arthrotomy
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 25040
Wrist arthrotomy
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
25040 without 50 · national facility
$524.73
Wrist arthrotomy
25040-50 · Bilateral: 150%
$787.10
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).
25040 compared with similar codes
Compare codes
25040 vs 25085 vs 25100 vs 25028: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25085Wrist capsulotomy
- 25040 opens the radiocarpal or midcarpal joint for exploration, drainage, or foreign-body removal. 25085 is a wrist capsular incision for a different operative purpose.
- 25100Wrist biopsy
- 25100 is a wrist arthrotomy performed to obtain a biopsy. Choose 25040 when the operative purpose is exploration, drainage, or removal of an intra-articular foreign body.
- 25028Collection drainage
- 25028 addresses a deep forearm or wrist soft-tissue abscess or hematoma. 25040 is for access to the radiocarpal or midcarpal joint.
25040 billing questions
When should this code be chosen instead of a wrist capsulotomy code?
Use 25040 for opening the radiocarpal or midcarpal joint to explore, drain, or remove a foreign body. A capsular incision for a different purpose is not the service described by this code.
Does the code include exploration, drainage, or foreign-body removal?
Those are the purposes covered by the arthrotomy service. The operative note should state the joint entered and which work was performed.
What documentation supports reporting 25040?
Document the radiocarpal or midcarpal joint approach and the indication and work, such as operative drainage of the joint or removal of an intra-articular foreign material.
How is bilateral wrist surgery reported?
For a bilateral procedure reported with modifier 50, CMS pays 150% under the supplied fee schedule rule. The record should support the procedure on both wrists.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
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