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CMS RVU26D · Effective 2026-10-01

25215 Carpectomy Medicare reimbursement rates in Rhode Island

Reports surgical removal of the scaphoid, lunate, and triquetrum as a proximal row carpectomy, often used to address selected forms of wrist arthritis. Compare 25215 office and facility rates across CMS payment localities in Rhode Island.

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 25215 in Rhode Island?

Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$586.08

1 of 1 localities have a supported rate.

Payment area: Rhode Island

One mapped payment locality.

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.

Find 25215 in your payment locality →

Wrist surgery

About 25215: Proximal row carpectomy

Reports surgical removal of the scaphoid, lunate, and triquetrum as a proximal row carpectomy, often used to address selected forms of wrist arthritis.

A proximal row carpectomy removes the scaphoid, lunate, and triquetrum, the three bones forming the wrist’s proximal carpal row. A hand or orthopedic surgeon may perform it for selected cases of painful wrist arthritis, including arthritis after carpal injury or collapse, when the remaining joint surfaces can support the intended reconstruction. The operation is commonly performed in a hospital outpatient or ambulatory surgery setting, and may also be performed in an inpatient setting.

Report 25215 when the documented procedure removes the entire proximal row, rather than one carpal bone. The operative note should identify the bones removed, the side, the indication, and any distinct procedures performed in the same session. CMS assigns a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 25215

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 RVU7.94 · 46%
  • Practice expense (office) RVU7.85 · 45%
  • Malpractice RVU1.51 · 9%

2.2K

Medicare services in 2024 · #2389 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.

25215 compared with similar codes

Office rates for Rhode Island, from the same CMS release.

25210

Carpal bone removal

One bone

No office rate

Choose 25210 when the procedure removes one carpal bone. Use 25215 when all three bones of the proximal carpal row are removed.

25230

Radius resection

Partial bone removal

No office rate

25230 concerns partial removal of the radius, not removal of the proximal carpal row. Select based on the bone actually resected.

25240

Ulna ostectomy

Partial bone removal

No office rate

25240 concerns partial removal of the ulna. It is not the code for a proximal row carpectomy.

25800

Wrist fusion

Complete, without graft

No office rate

25215 removes the proximal carpal row; 25800 is wrist arthrodesis. The operative plan and documented procedure distinguish carpectomy from fusion.

Compare 25215 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 25215 in Rhode Island.

PPRRVU2026_Oct_nonQPP.csv

2,410

Code
25215
Physician work
7.94
Practice expense
7.85
Malpractice
1.51

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 25215 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work7.94× 1.0198.0909
Practice expense7.85× 1.0338.1090
Malpractice1.51× 0.8921.3469
Total RVUs17.5468
Conversion factor× 33.4009

Facility rate, Rhode Island$586.08

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.941.019
Practice expense7.851.033
Malpractice1.510.892

(7.94 × 1.019 + 7.85 × 1.033 + 1.51 × 0.892) × $33.4009 = $586.08

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

25215 billing questions

How does 25215 differ from 25210?

25215 is for removal of the entire proximal carpal row: the scaphoid, lunate, and triquetrum. 25210 describes removal of one carpal bone, not the full row.

What documentation supports 25215?

Document the wrist side, the indication, and removal of all three proximal-row bones. The operative report should also identify any separate procedures performed during the session.

Does the 90-day global period include postoperative care?

Yes. CMS includes the day-before preoperative visit and related postoperative care for 90 days in the global period.

How is bilateral 25215 paid?

CMS pays a bilateral procedure reported with modifier 50 at 150%. The operative documentation should support that the procedure was performed on both wrists.

Can an assistant or co-surgeon be reported?

CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does CMS handle other procedures in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

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.

RVUs for 25215PPRRVU2026_Oct_nonQPP.csv, line 2,410 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)