No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
25040 Wrist arthrotomy Medicare reimbursement rates in Georgia
A surgeon opens the radiocarpal or midcarpal wrist joint to explore it, drain it, or remove an intra-articular foreign body. Compare 25040 office and facility rates across CMS payment localities in Georgia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 25040 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$508.96–$538.91
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 25040: Radiocarpal or midcarpal joint arthrotomy
A surgeon opens the radiocarpal or midcarpal wrist joint to explore it, drain it, or remove an intra-articular foreign body.
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.
CMS billing rules for 25040
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.31 · 47%
- Practice expense (office) RVU6.95 · 44%
- Malpractice RVU1.45 · 9%
630
Medicare services in 2024 · #3352 by national volume
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 compared with similar codes
Office rates for Georgia, from the same CMS release.
No office rate
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.
No office rate
25028 addresses a deep forearm or wrist soft-tissue abscess or hematoma. 25040 is for access to the radiocarpal or midcarpal joint.
Compare 25040 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Atlanta →
Office / nonfacility
Unavailable
Facility
$538.91
Rest Of Georgia →
Office / nonfacility
Unavailable
Facility
$508.96
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,37425028,,I&d f/arm&/wrst dp absc/hmtm,A,,5.26,14.27,NA,14.27,,1.07,20.60,20.60,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37525031,,I&d forearm&/wrist bursa,A,,4.15,5.86,NA,5.86,,0.89,10.90,10.90,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37625035,,Inc dp bone crtx f/arm&/wrst,A,,7.46,7.82,NA,7.82,,1.59,16.87,16.87,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37725040,,Arthrt rdcrpl/midcarpl jt,A,,7.31,6.95,NA,6.95,,1.45,15.71,15.71,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37825065,,Biopsy forearm soft tissues,A,,1.99,5.57,,2.10,,0.28,7.84,4.37,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37925066,,Biopsy forearm soft tissues,A,,4.16,5.75,NA,5.75,,0.82,10.73,10.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38025071,,Exc forearm les sc 3 cm/>,A,,5.76,5.07,NA,5.07,,1.28,12.11,12.11,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00