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CMS RVU26D · Effective 2026-10-01

25335 Wrist centralization Medicare reimbursement rates in Tennessee

Reports surgical repositioning of a radially displaced wrist over the ulna, commonly to correct wrist alignment in congenital radial deficiency. Compare 25335 office and facility rates across CMS payment localities in Tennessee.

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 25335 in Tennessee?

Tennessee 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

$800.44

1 of 1 localities have a supported rate.

Payment area: Tennessee

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 25335 in your payment locality →

Hand and wrist surgery

About 25335: Wrist centralization over the ulna

Reports surgical repositioning of a radially displaced wrist over the ulna, commonly to correct wrist alignment in congenital radial deficiency.

This operation repositions the carpus over the distal ulna to address radial-sided wrist displacement, most often in a patient with congenital radial longitudinal deficiency, sometimes called radial club hand. A pediatric orthopedic or hand surgeon performs the reconstruction in an operating room. The procedure may involve releasing contracted soft tissues and stabilizing the repositioned wrist, as needed to achieve the planned alignment.

Report 25335 when the operative objective is centralizing the wrist on the ulna; document the underlying deformity, side, structures addressed, and the repositioning and stabilization performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

CMS billing rules for 25335

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 not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU13.06 · 50%
  • Practice expense (office) RVU10.36 · 40%
  • Malpractice RVU2.77 · 11%

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.

25335 compared with similar codes

Office rates for Tennessee, from the same CMS release.

25320

Wrist stabilization

Carpal instability

No office rate

25335 centers the carpus over the ulna. 25320 is used for a wrist joint repair or revision when the surgeon is not performing that centralization.

25332

Wrist arthroplasty

With or without interposition

No office rate

25335 corrects wrist position over the ulna. 25332 describes wrist joint arthroplasty, a different operation and objective.

25337

Joint reconstruction

Distal radioulnar joint

No office rate

25335 repositions the carpus on the ulna; 25337 concerns reconstruction of the distal radioulnar joint.

Compare 25335 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 25335 in Tennessee.

PPRRVU2026_Oct_nonQPP.csv

2,436

Code
25335
Physician work
13.06
Practice expense
10.36
Malpractice
2.77

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Facility calculation for 25335 in Tennessee
ComponentRVULocality factorAdjusted
Physician work13.06× 1.00013.0600
Practice expense10.36× 0.9099.4172
Malpractice2.77× 0.5371.4875
Total RVUs23.9647
Conversion factor× 33.4009

Facility rate, Tennessee$800.44

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work13.061
Practice expense10.360.909
Malpractice2.770.537

(13.06 × 1 + 10.36 × 0.909 + 2.77 × 0.537) × $33.4009 = $800.44

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.

25335 billing questions

When is 25335 appropriate instead of a wrist joint repair code?

Use 25335 when the operative goal is to reposition the carpus over the ulna, typically for radial-sided wrist displacement. A wrist joint repair or reconstruction code describes a different operative objective.

Does the 90-day global include postoperative visits?

Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral centralization reported?

For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

Can another procedure be reported during the same session?

A distinct procedure may be subject to the standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50%. The operative record should support each service performed.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid for this procedure. Co-surgeons and team surgery are not permitted under the CMS rules 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.

RVUs for 25335PPRRVU2026_Oct_nonQPP.csv, line 2,436 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet