CPT 25250: Removal of Implanted Artificial Wrist Joint
CPT code 25250 represents the surgical removal of a previously implanted artificial wrist joint, a procedure performed when a wrist prosthesis fails, becomes infected, or causes an adverse reaction. Nationally, explantation procedures like this are clinically significant because they address device complications that can affect function, infection control, and long-term patient outcomes. The code is used to document and bill for the operative service of removing the implanted wrist device.
Key payers discussed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of coding and clinical context for explantation of wrist prostheses, common sites of service, and typical service type. The publication also summarizes benchmark considerations and policy-relevant topics that influence coverage and reimbursement for device removal procedures.
This report provides: a clear description of what CPT code 25250 covers; the typical clinical indications prompting explantation; the usual care settings where the procedure is performed; and an outline of payer coverage scope. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 25250 describes the surgical removal of a previously implanted artificial wrist joint. This procedure is typically performed when an implanted wrist device fails, becomes infected, or prompts an adverse reaction requiring explantation.
Service Type: Surgical explantation of implanted wrist prosthesis
Typical Site of Service: Hospital operating room or ambulatory surgery center
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of total wrist arthroplasty presents with increasing wrist pain, decreased range of motion, and signs of implant failure including loosening and radiographic hardware migration. The patient reports progressive functional decline over several months and has localized swelling and episodes of erythema near the surgical site. Prior conservative measures failed. After orthopaedic hand surgery evaluation, imaging (plain radiographs, possible CT) confirms prosthesis loosening and periprosthetic osteolysis. The multidisciplinary workflow includes preoperative evaluation by the orthopaedic surgeon and anesthesiology, informed consent discussing risks of explantation and reconstruction or conversion to arthrodesis, preoperative antibiotics if infection is suspected, surgical removal of the failed artificial wrist joint (25250) in an operating room or ambulatory surgical center, intraoperative cultures if infection is a concern, possible immediate conversion to wrist arthrodesis or placement of spacer, and postoperative wound care with appropriate follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to remove the implant is substantially greater than usual due to complexity, extensive scar tissue, or intraoperative complications. |
23 | Unusual anesthesia | Use when general anesthesia is required for unusual circumstances when local/regional would normally be used (rare for this code). |
26 | Professional component | Use when reporting only the professional component (typically not applicable for surgical services billed by the operating surgeon). |
50 | Bilateral procedure | Use when removal of bilateral wrist prostheses is performed during the same operative session. |
51 | Multiple procedures | Use when 25250 is one of multiple distinct procedures performed during the same operative session (follow payer rules for multiple procedure reductions). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances prior to completion. |
54 | Surgical care only | Use when the surgeon bills only for the surgical portion and another provider bills for pre- or post-operative care. |
55 | Postoperative management only | Use when billing only for postop care after a different surgeon performed the operative procedure. |
76/77 (not in list) | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 206E00000X | Orthopaedic Surgery | Primary specialty performing implant removal and revision/arthrodesis procedures. |
| 207L00000X | Hand Surgery (Orthopaedic) | Focused hand and wrist surgeons experienced with complex wrist arthroplasty explantation. |
| 2080P0228X | General Surgery (Plastic & Reconstructive Surgery) | May be consulted for soft-tissue management, salvage, or reconstruction around the wrist. |
| 363LF0000X | Anesthesiology | Provides perioperative anesthesia care in OR or ambulatory settings. |
| 3336C0002X | Infectious Disease | Consulted when periprosthetic infection is suspected; guides antibiotic therapy and culture interpretation. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
20680 | Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate) | May be used for removal of deep fixation hardware in the distal radius or ulna in the same operative episode if present. |
25260 | Excision of wrist joint with or without interposition arthroplasty (minor codes vary) | Represents alternative reconstructive procedures such as excision arthroplasty that may follow explantation if conversion is planned. |
25447 | Arthrodesis, wrist; with internal fixation (includes graft if performed) | Commonly performed immediately or staged after implant removal when conversion to wrist fusion is chosen for salvage. |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa | Used preoperatively for joint aspiration to obtain synovial fluid for culture when infection is suspected. |
10180 | Incision and drainage, complex, postoperative wound infection or complicated soft tissue | May be performed if wound infection or abscess is encountered before or after explantation. |