No office rate
Use 25441 when the prosthetic replacement target is the distal radius. This code identifies the distal scaphoid and carpus instead.
On this page
CMS RVU26D · Effective 2026-10-01
25443 Wrist arthroplasty Medicare reimbursement rates in Wyoming
Reports wrist arthroplasty using a prosthetic replacement for the distal scaphoid and carpus when that specific anatomy is surgically treated. Compare 25443 office and facility rates across CMS payment localities in Wyoming.
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 25443 in Wyoming?
Wyoming 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
$718.39
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Orthopedic surgery
About 25443: Distal scaphoid prosthetic arthroplasty
Reports wrist arthroplasty using a prosthetic replacement for the distal scaphoid and carpus when that specific anatomy is surgically treated.
An orthopedic hand or wrist surgeon uses this code when performing arthroplasty with prosthetic replacement involving the distal scaphoid and carpus. The procedure is generally performed in an operating room for a patient whose affected wrist anatomy is being treated with an implant. The operative report should identify the structures replaced and document the prosthetic work performed.
Report the code for the documented distal scaphoid and carpal target, not for replacement of a different wrist bone or a broader joint reconstruction. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25443
- 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 RVU10.39 · 47%
- Practice expense (office) RVU9.49 · 43%
- Malpractice RVU2.20 · 10%
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.
25443 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 25444 for prosthetic replacement of the lunate; this code concerns the distal scaphoid and carpus.
No office rate
Use 25445 when the prosthetic replacement target is the trapezium, rather than the distal scaphoid and carpus.
No office rate
Use 25446 when the documented prosthetic arthroplasty involves the distal radius and carpus. This code identifies the distal scaphoid and carpus.
Compare 25443 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$718.39
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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 25443 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,460
- Code
- 25443
- Physician work
- 10.39
- Practice expense
- 9.49
- Malpractice
- 2.20
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.39 | × 1.000 | 10.3900 |
| Practice expense | 9.49 | × 1.000 | 9.4900 |
| Malpractice | 2.20 | × 0.740 | 1.6280 |
| Total RVUs | 21.5080 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$718.39
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.39 | 1 |
| Practice expense | 9.49 | 1 |
| Malpractice | 2.2 | 0.74 |
(10.39 × 1 + 9.49 × 1 + 2.2 × 0.74) × $33.4009 = $718.39
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.
25443 billing questions
How do I distinguish this code from other wrist prosthetic arthroplasties?
Select it when the operative documentation identifies the distal scaphoid and carpus as the prosthetic replacement target. Codes for the distal radius, ulna, lunate, or trapezium identify different anatomy.
What documentation supports reporting this code?
The operative report should identify the distal scaphoid and carpal structures treated and describe the prosthetic replacement performed. Documentation of a different bone or reconstruction target points to a different code.
Does this code have a 90-day global period?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is a bilateral procedure reported?
CMS identifies this as a bilateral procedure; 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 with supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
2,45725440,,Repair nonu scphd carpl b1,A,,10.41,8.69,NA,8.69,,2.00,21.10,21.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45825441,,Arthrp w/prostc dstl rds,A,,12.96,10.31,NA,10.31,,2.75,26.02,26.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,45925442,,Arthrp w/prostc dstl ulna,A,,10.84,9.28,NA,9.28,,2.05,22.17,22.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46025443,,Arthrp prostc dstl scph crpl,A,,10.39,9.49,NA,9.49,,2.20,22.08,22.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46125444,,Arthrp w/prostc lunate,A,,11.13,9.46,NA,9.46,,2.15,22.74,22.74,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,46225445,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,