CPT code 25446 represents an extensive reconstructive orthopedic procedure that replaces the radial head and portions of the carpus with prosthetic implants, accompanied by excision of the radial and ulnar heads and removal of selected carpal bones. Nationally, this code captures high-complexity wrist and distal forearm reconstructions that have implications for surgical resource use, device utilization, and postoperative rehabilitation planning. Key payers in typical coverage and payment analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical scope and billing context of the procedure, common sites of service, and typical payer coverage landscape. The publication provides benchmarks for utilization and spending where available, summarizes relevant policy and coding considerations affecting authorization and claims adjudication, and situates the procedure within clinical care pathways for severe wrist and distal forearm pathology. Data not available in the input will be noted where applicable. The content is intended for a national audience of clinicians, coding professionals, and payer policy staff seeking a concise reference on CPT code 25446.