No office rate
Use 25448 when the interposition reconstruction includes suspension. Code 25447 describes the related interposition arthroplasty without suspension.
On this page
CMS RVU26D · Effective 2026-10-01
25448 Wrist arthroplasty Medicare reimbursement rates in Tennessee
Reports interposition arthroplasty with suspension for an intercarpal or carpometacarpal joint, commonly used to reconstruct the thumb base after painful arthritis. Compare 25448 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 25448 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
$752.54
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.
Hand surgery
About 25448: Intercarpal or carpometacarpal suspension arthroplasty
Reports interposition arthroplasty with suspension for an intercarpal or carpometacarpal joint, commonly used to reconstruct the thumb base after painful arthritis.
This procedure reconstructs an intercarpal or carpometacarpal joint using interposition and suspension techniques. A common setting is surgery for painful thumb carpometacarpal, or basal-joint, arthritis, where the surgeon removes the trapezium and stabilizes the first metacarpal. An orthopedic or hand surgeon typically performs the operation in a hospital or ambulatory surgery center. The suspension component distinguishes this service from interposition arthroplasty without that component.
Report the code when the operative work includes the specified joint reconstruction with suspension; the operative report should identify the treated joint and describe the reconstruction 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 multiple-procedure reduction. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 25448
- 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 RVU11.55 · 47%
- Practice expense (office) RVU10.78 · 44%
- Malpractice RVU2.20 · 9%
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.
25448 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
This code describes prosthetic replacement of the trapezium, rather than interposition arthroplasty with suspension.
No office rate
This code is for revision of a wrist arthroplasty, not primary intercarpal or carpometacarpal reconstruction with suspension.
Compare 25448 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$752.54
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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 25448 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
2,465
- Code
- 25448
- Physician work
- 11.55
- Practice expense
- 10.78
- Malpractice
- 2.20
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.55 | × 1.000 | 11.5500 |
| Practice expense | 10.78 | × 0.909 | 9.7990 |
| Malpractice | 2.20 | × 0.537 | 1.1814 |
| Total RVUs | 22.5304 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$752.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.55 | 1 |
| Practice expense | 10.78 | 0.909 |
| Malpractice | 2.2 | 0.537 |
(11.55 × 1 + 10.78 × 0.909 + 2.2 × 0.537) × $33.4009 = $752.54
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.
25448 billing questions
How does 25448 differ from 25447?
25448 describes interposition arthroplasty with suspension. Use 25447 for the related interposition arthroplasty without the suspension component.
What documentation supports reporting 25448?
The operative report should identify the intercarpal or carpometacarpal joint treated and describe both the interposition reconstruction and suspension work.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation.
How is bilateral 25448 handled?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can 25448 be reported with another procedure performed in the same session?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
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.
2,46225445,,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
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
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780