Wrist arthrodesis performed using a sliding bone graft technique to fuse the radiocarpal and/or intercarpal joints into a single solid construct.
Verified May 8, 2026 · 7 sources ↓
- Medicare
- $792.27
- Total RVUs
- 23.72
- Global, days
- 90
- Region
- Wrist
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 7 cited references ↓
- Specify the exact joints fused (radiocarpal, intercarpal, carpometacarpal, or combination) — 'complete wrist fusion' alone is insufficient
- Document that a sliding graft technique was used and describe graft orientation, source (local cortical/corticocancellous), and preparation
- Record preoperative diagnosis with supporting imaging — payers require imaging correlation for arthritis, instability, or deformity indications
- Document fixation method (plate, K-wires, screws) and intraoperative fluoroscopy findings confirming alignment
- Include prior conservative or surgical treatment history establishing medical necessity for fusion over motion-preserving alternatives
- Note laterality (left, right) in both the operative report header and the body of the note to support LT/RT modifier application
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 7 cited references ↓
CPT 25805 describes a complete wrist arthrodesis in which a sliding graft — cortical or corticocancellous bone slid into position across the fusion site — provides structural support while the joint surfaces are prepared and fixed. This distinguishes it from 25800 (no graft) and 25810 (iliac or other autograft requiring a separate harvest). The procedure is indicated for end-stage wrist arthritis, post-traumatic deformity, carpal instability, or failed prior wrist procedures where stability and pain relief outweigh the loss of motion.
The 90-day global period covers all routine post-op care through day 90. New problems, hardware complications requiring return to the OR, or procedures on a separate anatomic site all need the appropriate modifier. Bone graft harvest is not separately billable when it's integral to the sliding graft technique described in the code — per NCCI policy, graft procurement included in the primary code descriptor is not independently reportable.
Site of service matters here: HOPD and ASC reimbursement differ substantially (see the site-of-service comparison table on this page). Most commercial payers follow CMS global and bundling logic but verify prior authorization requirements, as wrist fusion is frequently subject to medical necessity review.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 11.44 |
| Practice expense RVU | 9.84 |
| Malpractice RVU | 2.44 |
| Total RVU | 23.72 |
| Medicare national rate | $792.27 |
| 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 | $792.27 |
HOPD (APC 5114) Hospital outpatient department | $7,413.38 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $3,695.53 |
Common denial reasons
The recurring reasons claims for CPT 25805 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Missing or vague graft documentation — payer downcodes to 25800 when sliding graft technique is not explicitly described
- Separate billing of bone graft harvest codes alongside 25805 — NCCI bundles graft procurement when it is integral to the primary descriptor
- Lack of medical necessity documentation: no imaging, no failed conservative treatment record, or absent prior surgical history
- Laterality modifier absent on bilateral payers or ASC claims requiring LT/RT on separate claim lines
- Global period violations — routine post-op visits billed without modifier 24 during the 90-day window
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 7 cited references ↓
01What separates 25805 from 25800 and 25810?
02Can bone graft harvest codes be billed separately with 25805?
03What modifier applies if this is performed bilaterally?
04Is fluoroscopy separately billable during wrist arthrodesis?
05How does the 90-day global period affect post-op billing?
06What ICD-10 diagnoses most commonly support 25805?
07When is modifier 22 appropriate for 25805?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02emedny.orghttps://www.emedny.org/providermanuals/physician/pdfs/physician%20procedure%20codes%20sect5.pdf
- 03cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 04bedrockbilling.comhttps://bedrockbilling.com/static/cci/25805
- 05cgsmedicare.comhttps://www.cgsmedicare.com/medicare_dynamic/j15/partb/ptpb/ptp.aspx
- 06aapc.comhttps://www.aapc.com/codes/cpt-codes/25805
- 07mdclarity.comhttps://www.mdclarity.com/cpt-code/25805
Mira AI Scribe
The Mira AI Scribe captures the surgeon's dictation of the sliding graft type, preparation technique, joint levels fused, fixation construct, and fluoroscopic confirmation of alignment — the exact details auditors and payer reviewers check when deciding whether 25805 is supported over 25800. Missing or generic graft language is the leading reason this code gets downgraded at claim review.
See how Mira captures CPT 25805 documentation