Open arthrotomy of the distal radioulnar joint with repair or debridement of the triangular fibrocartilage complex (TFCC).

Verified May 8, 2026 · 7 sources ↓

Medicare: $587.86
Work RVU: 7.51
Global, days: 90
Region: Wrist

Drawn from CMSAAPCGenhealthBedrockbillingCgsmedicare

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Operative note must name the specific surgical approach to the distal radioulnar joint, not just 'standard wrist incision'.
Document whether the TFCC was repaired with sutures, debrided, or both — the note must support the work performed.
Pre-operative imaging (MRI or X-ray) confirming TFCC pathology or DRUJ instability should be referenced in the note.
Specify traumatic vs. degenerative etiology to support ICD-10 code selection and medical necessity criteria.
Record anesthesia type, patient positioning, tourniquet use, and intraoperative findings including extent of cartilage damage.
Document failure of conservative management (e.g., immobilization, therapy, injections) prior to surgical intervention.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

25107 covers an open surgical approach to the distal radioulnar joint (DRUJ) for treatment of the triangular fibrocartilage complex — the cartilaginous and ligamentous structure that stabilizes the ulnar side of the wrist. The surgeon incises the wrist, opens the joint capsule, and either repairs torn TFCC tissue with sutures or debrides damaged cartilage, depending on the extent and type of pathology. It is performed by orthopedic or hand surgeons, typically under regional or general anesthesia in a hospital or ASC setting.

This is an open procedure, not arthroscopic. Coders often need to distinguish it from arthroscopic TFCC codes (e.g., 29847). The global period is 90 days, meaning all routine follow-up, splint or cast management, and wound care through day 90 are bundled. Separately billing post-op visits within the global window requires modifier 24 (unrelated E/M) or modifier 79 (unrelated procedure).

ICD-10 diagnosis codes should specify TFCC injury or DRUJ instability — degenerative vs. traumatic distinction matters for many commercial payers. Pre-operative MRI findings supporting TFCC pathology strengthen medical necessity documentation and reduce prior authorization friction.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (7.51) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.6) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.51
Practice expense RVU	8.64
Malpractice RVU	1.45
Total RVU	17.6
Medicare national rate	$587.86
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$587.86
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 25107 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Unbundling denial when arthroscopic TFCC codes are billed same-day without modifier 59 or XS establishing a distinct service.
Medical necessity denial due to absent or inadequate pre-operative imaging documentation supporting TFCC pathology.
Global period violation — post-op E/M or procedure claims within the 90-day window submitted without modifier 24 or 79.
Diagnosis-to-procedure mismatch when a non-specific wrist pain ICD-10 code is used instead of a TFCC-specific diagnosis.
Missing laterality — claims submitted without LT or RT modifier are flagged by many commercial and Medicare payers.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the global period for 25107, and what does it include?

25107 carries a 90-day global period. That bundles the surgery itself, the day-before pre-op visit, and all routine post-op care through day 90 including wound checks, cast or splint management, and stitch removal. Bill unrelated E/M visits in that window with modifier 24.

02How does 25107 differ from arthroscopic TFCC codes?

25107 is an open arthrotomy of the DRUJ. Arthroscopic TFCC repair uses 29847. If you're billing both an open and arthroscopic wrist procedure at the same session, modifier 59 or XS is required to bypass the bundling edit — and documentation must clearly support distinct, separately performed services.

03Which ICD-10 codes are typically paired with 25107?

TFCC tear codes — traumatic (S63.001–S63.099 range) or degenerative (M19.031/M19.032) — are the primary pairings. DRUJ instability (M25.331/M25.332) is also used. Avoid non-specific wrist pain codes (M79.621/M79.622) as the primary diagnosis; payers routinely deny on medical necessity grounds.

04Can 25107 be billed with an E/M on the same day?

Yes, if the E/M is a separately identifiable decision for surgery made at that visit. Attach modifier 57 to the E/M when it represents the decision for major surgery. If the E/M is purely routine pre-op, it folds into the global and is not separately billable.

05Is modifier 50 appropriate for 25107?

Bilateral TFCC open repair at the same session is rare but not impossible. If you're billing bilateral, use modifier 50 and confirm payer policy — some payers require LT/RT on separate lines instead of modifier 50 on a single line.

06What supports a modifier 22 claim for increased procedural complexity on 25107?

Significant additional work beyond typical TFCC repair — such as extensive adhesiolysis, prior surgical scarring requiring takedown, or concomitant DRUJ reconstruction — can support modifier 22. Document total operative time, specific complicating factors, and why the work exceeded the standard procedure. A cover letter with the claim improves approval rates.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the surgical approach to the distal radioulnar joint, TFCC repair vs. debridement distinction, intraoperative findings, and laterality directly from the surgeon's dictation. It also flags when pre-op imaging or conservative treatment failure isn't referenced in the note — the most common reason 25107 claims face medical necessity denials on audit.

See how Mira captures CPT 25107 documentation