Billing code 25443: Wrist arthroplastyMedicare rate & RVUs in Delaware
Reports wrist arthroplasty using a prosthetic replacement for the distal scaphoid and carpus when that specific anatomy is surgically treated.
CMS doesn’t publish an office rate for 25443 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 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.
25443 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $728.00 |
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
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
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 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.
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).
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.
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.
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
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