25447 Interposition arthroplasty Medicare reimbursement rates in Iowa

This code describes reconstruction of an intercarpal or carpometacarpal joint using an interposed tissue or other reconstructive material. A common application is surgery for painful thumb carpometacarpal osteoarthritis, often involving trapeziectomy and tendon interposition, including ligament reconstruction and tendon interposition techniques. Orthopedic or hand surgeons typically perform the procedure in an operating room, often in a hospital outpatient department or ambulatory surgery center.

Select the code when the operative service is an interposition arthroplasty, rather than prosthetic replacement or a suspensionplasty technique. The operative report should identify the joint treated and describe the reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.