25442 Ulna arthroplasty Medicare reimbursement rates in Indiana

An orthopedic or hand surgeon replaces the distal end of the ulna with a prosthesis to address painful dysfunction or instability at the distal radioulnar joint. The procedure may be considered when disease or prior treatment has damaged the joint, including after distal ulna resection. It is generally performed in an operative facility, with the implant intended to restore support and function at the ulnar side of the wrist.

Select this code when the operative service includes prosthetic replacement of the distal ulna; the specific structure replaced, not just a diagnosis such as wrist arthritis, distinguishes it from nearby prosthetic arthroplasty codes. The operative report should identify the side, the distal ulna as the replaced structure, and the prosthesis placement. CMS assigns 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.