No office rate
25441 describes primary prosthetic arthroplasty of the distal radius. Use 25449 when the operative service revises an existing wrist arthroplasty.
On this page
CMS RVU26D · Effective 2026-10-01
25449 Wrist revision Medicare reimbursement rates in Pennsylvania
Revision wrist arthroplasty addresses a previously replaced wrist joint when the existing prosthetic reconstruction requires operative revision. Compare 25449 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 25449 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
$898.22–$973.51
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 25449: Revision of wrist joint arthroplasty
Revision wrist arthroplasty addresses a previously replaced wrist joint when the existing prosthetic reconstruction requires operative revision.
An orthopedic or hand surgeon revises a previously performed wrist joint arthroplasty when the prosthetic reconstruction has failed or requires correction. The operation may address problems such as implant loosening, wear, or instability. These procedures are generally performed in an operating room, with the operative report describing the prior reconstruction and the revision work performed on the wrist joint and implant construct.
Report this code for revision of an existing wrist arthroplasty, not for a first-time prosthetic replacement. Documentation should establish the prior arthroplasty, the reason for revision, and the work performed. CMS 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% reduction. 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.
CMS billing rules for 25449
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.57 · 52%
- Practice expense (office) RVU10.53 · 38%
- Malpractice RVU2.81 · 10%
148
Medicare services in 2024 · #4568 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.
25449 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
25443 is a primary prosthetic arthroplasty involving the distal scaphoid. It is not the revision code for a previously performed wrist arthroplasty.
No office rate
25446 describes primary prosthetic arthroplasty involving the distal radius and carpal bones; 25449 is for revision of an existing wrist arthroplasty.
Compare 25449 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
$973.51
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$898.22
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25449 billing questions
When should this code be chosen instead of a primary wrist arthroplasty code?
Use 25449 when the surgeon revises a wrist joint that has already undergone arthroplasty. A first-time prosthetic replacement is represented by a code for the specific joint or bone being replaced.
What documentation supports reporting a revision?
Document the prior wrist arthroplasty, the reason it requires revision, and the specific revision work performed. The operative report should make clear that the procedure addresses the existing arthroplasty rather than creating a primary replacement.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The surgeon's related routine follow-up care during that period is part of the surgical package.
How is the code treated when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple procedure reduction.
Can modifier 50 be used for bilateral wrist revisions?
CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.
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.
2,46325446,,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
2,46625449,,Revj arthrp wrist joint,A,,14.57,10.53,NA,10.53,,2.81,27.91,27.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46725450,,Epiphysl arrst dstl rds/ulna,A,,7.86,8.14,NA,8.14,,1.67,17.67,17.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46825455,,Epiphysl arrst dstl rds&ulna,A,,9.47,9.21,NA,9.21,,2.02,20.70,20.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46925490,,Prophylactic tx radius,A,,9.49,8.81,NA,8.81,,2.02,20.32,20.32,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00