Summary & Overview

CPT 25810: Wrist Arthrodesis with Iliac Crest Bone Graft

CPT code 25810 represents wrist arthrodesis using an autologous iliac crest bone graft, a definitive orthopedic procedure to fuse wrist joints for pain relief and stabilization. Nationally, this code matters because it is associated with complex reconstructive hand and wrist surgeries that can affect facility use, inpatient versus outpatient placement, and perioperative resource needs. Payers commonly involved in coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical context for CPT code 25810, typical sites of service, and the kinds of documentation and procedure descriptions that support coding and billing. The publication provides benchmarks and comparisons where available, notes common billing modifiers and data limitations, and summarizes policy or coverage trends that influence payment and utilization for wrist arthrodesis with iliac crest bone graft. The content is intended for coding professionals, revenue cycle staff, and clinical managers seeking a concise reference on the code’s clinical meaning, payer landscape, and where to look for further policy detail. Data not available in the input is identified explicitly where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare25810CPTwrist arthrodesisorthopedic surgerybone graftiliac cresthand surgeryambulatory surgeryinpatient surgery

Billing Code Overview

CPT code 25810 describes a surgical procedure in which the provider fuses wrist joints (arthrodesis) using a bone graft harvested from the patient's iliac crest (top of the pelvis). The service involves joining carpal and/or radiocarpal joint surfaces to eliminate motion and stabilize the wrist.

Service type: Surgical — open orthopedic procedure involving wrist arthrodesis with autologous iliac crest bone graft.

Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting depending on clinical indications and patient status).

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–70-year-old adult with progressive wrist pain, instability, and symptomatic arthritis of one or more carpal rows following prior distal radius fracture, scaphoid nonunion, Kienböck disease, or advanced scapholunate collapse. The patient presents to an orthopedic hand surgeon after failing conservative therapy (splinting, activity modification, corticosteroid injection, and physical therapy). Preoperative evaluation includes history and physical, targeted wrist radiographs and CT to assess joint alignment and bone stock, and evaluation for donor-site suitability at the iliac crest.

On the day of surgery the patient is brought to the ambulatory surgery center or hospital operating room. Regional anesthesia (brachial plexus block) with general anesthesia as needed is common. The surgeon exposes the involved wrist, prepares joint surfaces, places an autologous iliac crest bone graft, and performs carpal arthrodesis (wrist fusion) using internal fixation (plates, screws, or K-wires) to achieve union. The iliac donor site is closed in standard fashion. Postoperative workflow includes recovery room monitoring, immobilization in a cast or splint, instructions for wound and donor-site care, pain management, and scheduling of follow-up radiographs to confirm progressive fusion over 8–12 weeks. Typical sites of service are the hospital operating room or an ambulatory surgery center. Service type is operative orthopedic surgery of the wrist with autologous bone graft harvest from the iliac crest.

Coding Specifications

Modifier	Description	When to Use
`22`

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Hand and wrist reconstruction and arthrodesis are typically performed by orthopedic surgeons with hand specialization.
207K00000X	Hand Surgery (Orthopedic)	Focused specialty for complex wrist procedures and carpal fusions.
2080P0002X	Plastic Surgery	Plastic surgeons with hand subspecialty may perform wrist arthrodesis and bone grafting.
363LP0800X	Podiatry	Not typically applicable; included only if multidisciplinary care involves bone graft principles (rare).
261QC0400X	General Surgery	Rarely involved; included for completeness when multispecialty management occurs (uncommon).

CPT Code	Description	Relationship to This Procedure
`20610`	Bone graft, large (autograft), any donor, for spine or major bone reconstruction; first segment or site	Used to report substantial iliac crest graft harvest when separate extensive grafting is performed (may be considered in addition to wrist fusion when significant grafting documented).
`25440`	Arthrodesis, wrist; partial or complete, with or without internal fixation	Often reported for wrist fusion procedures involving carpal bones; choice depends on exact fusion level.
`20680`	Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod)	May be performed later if hardware removal is required after union.
`29848`	Arthroscopy, wrist, surgical; with removal of loose body, or synovectomy	May be performed prior to or concomitantly for diagnostic or limited therapeutic purposes in the wrist.
`11010`	Debridement of open wound, bone; first stage of treatment (includes irrigation and debridement)	Relevant if infection necessitates debridement before arthrodesis and grafting.

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