No office rate
Choose 25445 for prosthetic replacement of the trapezium. Choose 25447 when the surgeon performs interposition arthroplasty instead.
On this page
CMS RVU26D · Effective 2026-10-01
25445 Trapezium arthroplasty Medicare reimbursement rates in Pennsylvania
Reports operative arthroplasty replacing the trapezium with a prosthesis, commonly selected for reconstruction of painful thumb-base joint disease. Compare 25445 office and facility rates across CMS payment localities in Pennsylvania.
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 25445 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$637.61–$693.28
2 of 2 localities have a supported rate.
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.
Hand surgery
About 25445: Trapezium prosthetic replacement arthroplasty
Reports operative arthroplasty replacing the trapezium with a prosthesis, commonly selected for reconstruction of painful thumb-base joint disease.
This service is an operative arthroplasty in which a prosthetic implant replaces the trapezium, the carpal bone at the base of the thumb. It is most often encountered in reconstruction for painful thumb carpometacarpal disease when the surgeon selects a trapezial prosthesis. An orthopedic hand surgeon typically performs the procedure in an operating room, such as in a hospital outpatient department or ambulatory surgery center.
Report the code when the operative record supports prosthetic replacement of the trapezium, rather than trapeziectomy with interposition or suspensionplasty. Documentation should identify the treated side, the operative indication, and the prosthetic replacement performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for bilateral surgery is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 25445
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.63 · 48%
- Practice expense (office) RVU8.39 · 42%
- Malpractice RVU1.86 · 9%
427
Medicare services in 2024 · #3676 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.
25445 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
25448 represents suspensionplasty at intercarpal or carpometacarpal joints; 25445 is for prosthetic replacement of the trapezium.
No office rate
Both involve prosthetic replacement arthroplasty, but 25443 applies to the scaphoid and 25445 to the trapezium.
No office rate
25446 covers prosthetic arthroplasty involving the distal radius and carpal bones; 25445 identifies trapezium replacement.
Compare 25445 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$693.28
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$637.61
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25445 billing questions
How does this differ from trapeziectomy with interposition?
Report 25445 when the surgeon replaces the trapezium with a prosthesis. Interposition arthroplasty is a different technique and is represented by 25447.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
How is bilateral surgery reported?
For bilateral procedures, modifier 50 applies; CMS pays the service at 150%.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
Can an assistant surgeon be paid for this procedure?
CMS applies a statutory restriction on assistant-at-surgery payment for this code. Co-surgeon payment is allowed only with supporting documentation.
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.
2,45925442,,Arthrp w/prostc dstl ulna,A,,10.84,9.28,NA,9.28,,2.05,22.17,22.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46025443,,Arthrp prostc dstl scph crpl,A,,10.39,9.49,NA,9.49,,2.20,22.08,22.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46125444,,Arthrp w/prostc lunate,A,,11.13,9.46,NA,9.46,,2.15,22.74,22.74,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46225445,,Arthrp w/prostc trapezium,A,,9.63,8.39,NA,8.39,,1.86,19.88,19.88,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46325446,,Arthrp w/prostc dst rds&crps,A,,16.87,11.34,NA,11.34,,3.28,31.49,31.49,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46425447,,Arthrp ntrcrp/crp/mtcr ntrps,A,,10.24,10.07,NA,10.07,,1.96,22.27,22.27,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46525448,,Arthrp ntrcrpl/crp/mtcrp ssp,A,,11.55,10.78,NA,10.78,,2.20,24.53,24.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00