Billing code 25337: Joint reconstructionMedicare rate & RVUs in Nevada

Reconstructs the distal radioulnar joint to address persistent instability, including cases where the surgeon uses a tendon graft for stabilization.

CMS RVU26DEffective Oct 1, 20261 payment locality495 Medicare services in 2024

CMS doesn’t publish an office rate for 25337 in Nevada.

—Office (non-facility)
$816.50Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 25337 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nevada
  2. What 25337 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 25337 covers

This operation stabilizes the joint between the radius and ulna near the wrist when it remains unstable, often after trauma such as a Galeazzi injury or distal radius fracture. An orthopedic or hand surgeon performs the reconstruction in an operating room; a tendon graft may be used to restore support. The operative target is the distal radioulnar joint, not a general wrist ligament or a bony shortening procedure.

Report the code when the documented procedure reconstructs this joint, whether or not a tendon graft is used. The record should identify the instability, the joint treated, the reconstructive work, and laterality. 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 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 is restricted; co-surgeons and team surgery are not permitted.

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.

25337 in Nevada**

25337 office and facility rates by payment locality
Payment localityOfficeFacility
Nevada**Unavailable$816.50

How the 25337 rate is calculated

Each of 25337’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 25337

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.44Practice expense 11.17Malpractice 2.19

24.8000 adjusted RVUs×$33.4009 conversion factor=$828.34

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25337

25337 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25337

Joint reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25337

Joint reconstruction

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25337 without 50 · national facility

$828.34

Joint reconstruction

25337-50 · Bilateral: 150%

$1,242.51

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

25337 compared with similar codes

Compare codes

25337 vs 25320 vs 25676 vs 25360: national Medicare rates

Swap in your local Medicare rate.

  • 25337
    Joint reconstruction · 11.44 wRVU
    —
  • 25320
    Wrist stabilization · 12.43 wRVU
    —
  • 25676
    Joint reduction · 8.08 wRVU
    —
  • 25360
    Ulnar osteotomy · 8.52 wRVU
    —

How to choose

25320Wrist stabilization
This code targets reconstruction of the distal radioulnar joint. Code 25320 is for wrist-joint repair or reconstruction when the operative target is broader.
25676Joint reduction
Code 25676 describes open treatment of a distal radioulnar joint dislocation; 25337 is for reconstructing the joint to address instability.
25360Ulnar osteotomy
Code 25360 addresses an ulnar bone problem with an osteotomy. Use 25337 when the procedure reconstructs distal radioulnar joint stability.

25337 billing questions

When is this code used instead of a wrist reconstruction code?

Use it when the reconstructed structure is specifically the distal radioulnar joint and the goal is to address its instability. A broader wrist reconstruction code applies when the operative target is the wrist joint more generally.

Does use of a tendon graft change the code?

No. This code covers distal radioulnar joint reconstruction with or without a tendon graft. Document the graft use and the reconstructive work performed.

Does this code include related postoperative care?

Medicare assigns a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.

How is it paid when performed with another procedure in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Can it be reported bilaterally?

Yes. Medicare pays bilateral reporting with modifier 50 at 150%.

Can an assistant, co-surgeon, or surgical team be paid?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 25337PPRRVU2026_Oct_nonQPP.csv, line 2,437 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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