Unlisted code for an open procedure on the forearm or wrist that no listed code describes.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Wrist
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Operative note naming bones, ligaments, or tendons treated
- Approach (open or percutaneous) and fixation used
- Why no listed wrist, hand, or Category III code fits
- Comparison code
- Laterality
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 2 cited references ↓
25999 is the unlisted code for the forearm and wrist. Open or percutaneous procedures on the radius, ulna, carpus, and the soft tissue around them land here when nothing in the forearm and wrist section matches. Wrist arthroscopy without a code goes to 29999.
Hand surgeons use it for newer carpal procedures, unusual reconstructions, and some implant work. Check first whether the procedure fits a hand code (26000 range) or a Category III code. Coders sometimes reach for 25999 when the right answer is a listed code with modifier 52 for a reduced service, or a combination of listed codes.
Medicare has no fee and a YYY global, and the contractor prices from records. Include laterality and name the carpal bones involved. A good comparison code for wrist work is usually a listed open repair or arthroplasty with similar time. Send everything with the first claim. A complete first packet avoids the records request that otherwise stalls the claim for weeks.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | 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 | $0.00 |
HOPD (APC 5111) Hospital outpatient department | $252.01 |
Common denial reasons
The recurring reasons claims for CPT 25999 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Wrist arthroscopy billed under open unlisted code
- A hand code in the 26000 range applies
- Missing records with the initial claim
- No laterality
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01What does CPT 25999 cover?
02How do I pick a comparison code for 25999?
03Can I use 25999 for a hand procedure?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf
Mira Scribe
Mira Scribe records which carpal bones and soft tissue were treated and how, so the claim packet for an unlisted wrist case is complete on the first submission.
See how Mira captures CPT 25999 documentation