No office rate
Choose 25320 for wrist-joint stabilization due to carpal instability. Choose 25332 when the procedure is wrist arthroplasty.
On this page
CMS RVU26D · Effective 2026-10-01
25320 Wrist stabilization Medicare reimbursement rates in Hawaii
Reports operative repair or reconstruction of the wrist joint’s stabilizing structures when carpal instability requires surgical restoration of joint stability. Compare 25320 office and facility rates across CMS payment localities in Hawaii.
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 25320 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$952.82
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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 25320: Wrist joint stabilization repair
Reports operative repair or reconstruction of the wrist joint’s stabilizing structures when carpal instability requires surgical restoration of joint stability.
Code 25320 represents operative stabilization of the wrist for carpal instability. An orthopedic hand or upper-extremity surgeon repairs or reconstructs supporting joint structures, such as the capsule or ligaments, to restore stability and control abnormal carpal motion. This procedure may be performed in a hospital operating room or another surgical setting when instability is significant enough to require reconstruction rather than nonsurgical management.
Report the code when the operative objective is wrist-joint stabilization, not replacement of the joint or correction of radius or ulna length. The operative report should identify the instability, the structures addressed, the repair or reconstruction performed, and the treated side. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons and team surgery are not permitted.
CMS billing rules for 25320
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.43 · 45%
- Practice expense (office) RVU12.93 · 47%
- Malpractice RVU2.41 · 9%
1K
Medicare services in 2024 · #2968 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.
25320 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
25320 addresses carpal instability generally; 25337 specifically reconstructs the distal radioulnar joint.
No office rate
25335 describes centralization of the wrist on the ulna, not a general repair or reconstruction for carpal instability.
Compare 25320 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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$952.82
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 25320 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,434
- Code
- 25320
- Physician work
- 12.43
- Practice expense
- 12.93
- Malpractice
- 2.41
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.43 | × 1.000 | 12.4300 |
| Practice expense | 12.93 | × 1.137 | 14.7014 |
| Malpractice | 2.41 | × 0.579 | 1.3954 |
| Total RVUs | 28.5268 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$952.82
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.43 | 1 |
| Practice expense | 12.93 | 1.137 |
| Malpractice | 2.41 | 0.579 |
(12.43 × 1 + 12.93 × 1.137 + 2.41 × 0.579) × $33.4009 = $952.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
25320 billing questions
When is 25320 preferable to 25332?
Use 25320 when the operative goal is to stabilize a wrist with carpal instability. Code 25332 describes wrist arthroplasty, which addresses a different operative objective.
Does 25320 include routine postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is 25320 reported when both wrists are treated?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons and team surgery are not permitted for this code under the stated CMS rules.
How does the multiple-procedure reduction affect 25320?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What documentation supports reporting 25320?
Document the carpal instability, the wrist structures repaired or reconstructed, the stabilization performed, and the side treated.
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.
2,43125312,,Transplant forearm tendon,A,,9.57,8.43,NA,8.43,,1.88,19.88,19.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43225315,,Revise palsy hand tendon(s),A,,10.41,8.96,NA,8.96,,2.21,21.58,21.58,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43325316,,Revise palsy hand tendon(s),A,,12.58,10.21,NA,10.21,,2.68,25.47,25.47,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43425320,,Repair/revise wrist joint,A,,12.43,12.93,NA,12.93,,2.41,27.77,27.77,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43525332,,Revise wrist joint,A,,11.45,9.53,NA,9.53,,2.22,23.20,23.20,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43625335,,Centralization wrist on ulna,A,,13.06,10.36,NA,10.36,,2.77,26.19,26.19,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43725337,,Reconstruct ulna/radioulnar,A,,11.44,11.17,NA,11.17,,2.19,24.80,24.80,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014