25805 Wrist fusion Medicare reimbursement rates in Kentucky

An orthopedic or hand surgeon fuses the wrist bones to relieve pain and stabilize a severely damaged wrist, such as one affected by advanced arthritis, posttraumatic joint destruction, or chronic instability. In this approach, the surgeon uses a sliding bone graft as part of the fusion; the operative report should establish the fusion performed and the graft technique. The service is generally performed in a surgical facility rather than an office setting.

Report this code when the operative work is a complete wrist fusion using a sliding graft, rather than a limited fusion or a different graft approach. Documentation should identify the wrist, extent of fusion, indication, and use of the sliding graft. Medicare assigns a 90-day global period, including 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% multiple-procedure reduction. Modifier 50 for bilateral performance is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.