Summary & Overview
CPT 25830: Distal Radioulnar Joint Arthrodesis with Ulna Resection
CPT code 25830 represents surgical arthrodesis of the distal radioulnar joint with resection of the ulna, optionally including bone grafting. This code is used to report definitive operative management for symptomatic distal radioulnar joint disorders such as advanced degenerative disease, chronic instability, or post-traumatic conditions that impair forearm rotation and wrist function. Nationally, procedures coded with 25830 are relevant to orthopedic and hand surgery practice patterns and hospital surgical volumes.
Key payers commonly involved in coverage and reimbursement discussions for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and an outline of the billing landscape for 25830.
This publication provides benchmarks and coding guidance context (where available), highlights common clinical indications, and summarizes how 25830 is positioned among related upper-extremity surgical services. Data not available in the input is explicitly noted where applicable. The goal is to inform coding staff, surgical practices, and policy analysts about the code’s clinical meaning, typical utilization settings, and payer relevance on a national level.
Billing Code Overview
CPT code 25830 describes arthrodesis of the distal radioulnar joint with resection of the ulna, and may include bone grafting when performed. This procedure involves surgically fusing the distal radioulnar joint to stabilize the forearm and wrist, often combined with partial removal (resection) of the ulna to address pain, instability, or degenerative changes.
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Service type: Surgical procedure — upper extremity orthopedic surgery
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Typical site of service: Hospital inpatient or outpatient surgical center, or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 62-year-old right-hand–dominant patient presents with chronic wrist pain, instability, and progressive loss of forearm rotation after distal radius malunion with post-traumatic distal radioulnar joint (DRUJ) arthritis. Conservative care including physical therapy, splinting, steroid injection, and oral analgesics failed to relieve pain and restore function. Imaging (radiographs and CT) demonstrates symptomatic DRUJ arthrosis with ulnar impingement and positive ulnar variance. The orthopedic hand surgeon recommends surgical arthrodesis of the distal radioulnar joint with partial ulnar resection; intraoperative bone graft from local autograft may be used to promote fusion.
Clinical workflow:
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Preoperative evaluation including history, physical exam, and imaging to confirm DRUJ arthrosis and plan for resection arthrodesis.
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Pre-op clearance and informed consent discussing expected loss of DRUJ motion, pain relief goals, and potential need for bone graft.
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Intraoperative procedure: open resection of the distal ulna, preparation of fusion surfaces at the DRUJ, fixation (plates/screws or intramedullary devices), and optional bone graft harvest/placement.
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Postoperative care: immobilization in a cast or splint, serial radiographs to document fusion, pain control, and staged therapy for adjacent joint motion and strengthening.
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Typical site of service: hospital outpatient surgical unit or ambulatory surgery center for elective cases; inpatient setting if concurrent complex procedures or medical comorbidity require admission.
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Service type: orthopedic hand surgery — operative reconstructive procedure on the wrist/forearm.