No office rate
Both codes concern removal of a wrist prosthesis. Use 25251 when the removal is complicated and the operative note supports that added complexity; use 25250 for removal not meeting that level.
On this page
CMS RVU26D · Effective 2026-10-01
25251 Wrist implant removal Medicare reimbursement rates in Virginia
Reports complicated surgical removal of an implanted wrist joint prosthesis, such as an explant for infection, loosening, or mechanical failure. Compare 25251 office and facility rates across CMS payment localities in Virginia.
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 25251 in Virginia?
Virginia 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
$652.65–$754.25
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 25251: Complicated wrist implant removal
Reports complicated surgical removal of an implanted wrist joint prosthesis, such as an explant for infection, loosening, or mechanical failure.
This service covers surgical explantation of a wrist joint prosthesis when removal is complicated. An orthopedic hand or wrist surgeon may perform it in a hospital or ambulatory surgery setting for a failed, loose, infected, or painful implant. The work centers on exposing and extracting the prosthetic components; the operative report should establish why the removal was complicated and describe the additional technical work involved.
Choose this code rather than 25250 when the documented removal meets the complicated level; the implant and the difficulty of its extraction should be clear in the operative note. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. If multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral surgery, paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25251
- 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 RVU9.57 · 47%
- Practice expense (office) RVU8.67 · 43%
- Malpractice RVU2.05 · 10%
15
Medicare services in 2024 · #6060 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.
25251 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
25210 removes a wrist bone, not an implanted prosthetic device. Use it when the procedure is removal of the specified bone rather than prosthesis explantation.
No office rate
25215 concerns removal of multiple wrist bones. It does not describe removal of a wrist joint prosthesis.
Compare 25251 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$754.25
Virginia →
Office / nonfacility
Unavailable
Facility
$652.65
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25251 billing questions
How is 25251 different from 25250?
25251 is for complicated removal of a wrist prosthesis; 25250 is the related code for removal that does not meet the complicated level. The operative report should explain the added difficulty and work supporting 25251.
What documentation supports complicated removal?
Identify the wrist prosthesis and the reason for explantation, then describe the exposure, fixation, extraction challenges, and additional work that made removal complicated.
Can removal be reported with a new wrist prosthesis or fusion?
A surgeon may remove a failed implant and perform a new wrist reconstruction or fusion in the same session. Document each service performed and the distinct work; the multiple-procedure reduction applies when procedures are reported together.
How is bilateral removal reported?
For procedures on both wrists, report modifier 50; CMS pays this code at 150% for bilateral surgery.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
2,41325246,,Injection for wrist x-ray,A,,1.41,4.07,,0.29,,0.14,5.62,1.84,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41425248,,Remove forearm foreign body,A,,5.18,5.92,NA,5.92,,1.12,12.22,12.22,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41525250,,Removal of wrist prosthesis,A,,6.60,7.38,NA,7.38,,1.40,15.38,15.38,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41625251,,Removal of wrist prosthesis,A,,9.57,8.67,NA,8.67,,2.05,20.29,20.29,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41725259,,Manipulate wrist w/anesthes,A,,3.94,8.36,NA,8.36,,0.79,13.09,13.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41825260,,Repair forearm tendon/muscle,A,,7.84,8.59,NA,8.59,,1.51,17.94,17.94,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,41925263,,Repair forearm tendon/muscle,A,,7.84,8.69,NA,8.69,,1.67,18.20,18.20,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00