CPT 2025 Codes - Musculoskeletal System

Elbow

24140, 24145, 24147, 24149, 24150, 24152, 24155: Partial excision (craterization, saucerization, or diaphysectomy) (e.g., osteomyelitis).
- Radial head or neck (24145).
- Olecranon process (24147).
24155: Radical resection of tumor, shaft or distal humerus.
24160: Resection of elbow joint (arthrectomy).
Introduction or Removal
- For K-wire or pin insertion/removal, see 20650, 20670, 20680.
- For arthrocentesis or needling of bursa/joint, use 20605.
24160: Removal of prosthesis, including debridement and synovectomy when performed; humeral and/or both components.
24164: Removal of radial head prosthesis.
24200, 24201: Removal of foreign body, elbow.
- 24200: subcutaneous.
- 24201: deep (subfascial or intramuscular).
20680: Removal of hardware from distal humerus or proximal ulna (other than humeral and ulnar prosthesis).
24370, 24371, 24160: Do not report 24160 with 24370 or 24371 if prosthesis (humeral and/or ulnar components) is removed and replaced in the same elbow during surgical session.
24220: Injection procedure for elbow arthrography.
- For radiological supervision and interpretation, use 73085. Do not report 77002 with 73085.
- For injection for tennis elbow, use 20550.

Repair, Revision, and/or Reconstruction

24300: Manipulation, elbow, under anesthesia.
- For application of external fixation, see 20690 or 20692.
24301: Tendon transfer, any type, upper arm or elbow.
24305: Tendon lengthening, upper arm or elbow, each tendon.
24310: Tenotomy, elbow, each tendon.
24320: Tenoplasty, with muscle transfer, with or without free graft, elbow or shoulder (Seddon-Brookes type procedure).
24330: Flexorplasty, elbow (e.g., Steindler advancement).
24331: with extensor advancement.
24332: Tenolysis, elbow, each tendon.
24340: Tenodesis of biceps tendon at elbow (separate procedure).
24341: Repair, tendon, upper arm, elbow, each tendon or muscle, primary or secondary (excludes rotator cuff).
24342: Reinsertion of ruptured biceps tendon, distal, with or without tendon graft.
24343: Repair lateral collateral ligament, elbow, with local tissue; LCL.
24344: Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft); LCL.
24345: Repair medial collateral ligament, elbow, with local tissue; MCL.
24346: Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft); MCL.
24357: Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer's elbow), percutaneous.
24358: Debridement, soft tissue and/or bone, open; elbow.
24359: with tendon repair or reattachment.
24357-24359: Do not report with 29837.
24360: Arthroplasty, elbow, with membrane (e.g., fascia).
24361: with distal humeral prosthetic replacement.
24362: with implant and fascia lata ligament reconstruction.
24363: with distal humerus and proximal ulnar prosthetic replacement (e.g., total elbow).
24370, 24371: Revision of total elbow arthroplasty.
- 24370: includes allograft when performed; humeral and/or ulnar component.
- 24371: humeral or ulnar component.
24160, 24370, 24371: Do not report together if a prosthesis is being removed and replaced in the same elbow.
24400: Osteotomy, humerus, with or without internal fixation.
24410: Multiple osteotomies with realignment on intramedullary rod (Sofield type procedure).
24420: Osteoplasty, humerus (e.g., shortening or lengthening).
(excluding 64876): Neuroplasty.
24430: Repair of nonunion or malunion, humerus, without graft (e.g., compression technique).
24435: with iliac or other autograft (includes obtaining graft).
25400-25420: Proximal radius and/or ulna.
24470: Hemi-epiphyseal arrest (e.g., cubitus varus or valgus, distal humerus).
24495: Decompression fasciotomy, forearm, with brachial artery exploration.
24498: Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, humerus.

Fracture and/or Dislocation

Codes categorized by manipulation (reduction) and stabilization (fixation or immobilization).
Apply to open (compound) or closed fractures/ joint injuries.
24500: Closed treatment of humeral shaft fracture; without manipulation.
24505: with manipulation, with or without skeletal traction.
24515: Open treatment of humeral shaft fracture with plate/screws, with or without cerclage.
24516: Treatment of humeral shaft fracture with insertion of intramedullary implant, with or without cerclage and/or locking screws.
24530: Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation.
24535: with manipulation, with or without skin or skeletal traction.
24538: Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension.
24545: Treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed without intercondylar extension.
24546: with intercondylar extension.
24560: Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation.
24565: with manipulation.
24566: Percutaneous skeletal fixation of humeral epicondylar fracture, with manipulation.
24575: Open treatment of humeral epicondylar fracture, includes internal fixation when performed.
24576: Closed treatment of humeral condylar fracture, medial or lateral; without manipulation.
24577: with manipulation.
24579: Open treatment of humeral condylar fracture, medial or lateral includes internal fixation when performed.
To report closed treatment fractures without manipulation, see 24530, 24560, 24576, 24650, 24670.
To report closed treatment fractures with manipulation, see 24535, 24565, 24577, 24675.
24582: Percutaneous skeletal fixation of humeral condylar, medial or lateral, with manipulation.
24586: Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius).
24587: with implant arthroplasty (see also 24361).
24600: Treatment of closed elbow dislocation; without anesthesia.
(24605): requiring anesthesia.
24615: Open treatment of acute or chronic elbow dislocation.
24620: Treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation.
24625: Treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed.
24635: Treatment of radial head subluxation in child (nursemaid elbow), with manipulation.
24650: Closed treatment of radial head or neck fracture without manipulation.
24655: with manipulation.
24665: Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed.
24666: with radial head prosthetic replacement.
24670: Closed treatment of ulnar fracture, proximal end (e.g., olecranon or coronoid process[es]), without manipulation.
24675: with manipulation.
24685: Open treatment of ulnar fracture, proximal end (e.g., olecranon or coronoid process[es]), includes internal fixation, when performed.
(Do not report 24685 in conjunction with 24100-24102)
24800: Arthrodesis, elbow joint, local.
24802: with autogenous graft (includes obtaining graft).

Amputation

24900: Amputation, arm through humerus, with primary closure.
24920: open, circular (guillotine).
24925: secondary closure or scar revision.
24930: re-amputation.
24931: with implant.
24935: Stump elongation, upper extremity.
24940: Cineplasty, upper extremity, complete procedure.

Other Procedures

24999: Unlisted procedure, humerus or elbow.

Forearm and Wrist

Radius, ulna, carpal bones, and joints.
Incision
- 25000: Incision, extensor tendon sheath, wrist (e.g., de Quervain's disease).
  - For decompression median nerve for carpal tunnel syndrome, use 64721.
- 25001: Incision, flexor tendon sheath, wrist (e.g., flexor carpi ulnaris).
- 25020: Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; without debridement of nonviable muscle and/or nerve.
  - with debridement of nonviable muscle and/or nerve.
  - For decompression fasciotomy with brachial artery exploration, use 24495.
  - For incision and drainage procedures, superficial, see 10060–10160.
  - For debridement, see also 11000–11044.
- 25023: Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle and/or nerve.
  - with debridement of nonviable muscle and/or nerve.
- 25031: Incision and drainage, forearm and/or wrist, deep abscess or hematoma.
- 25035: Incision, bone cortex, forearm and/or wrist (e.g., osteomyelitis or bone abscess).
Arthrotomy
- 25040: Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body.

Excision

Biopsy, soft tissue of forearm and/or wrist
* superficial
* deep (subfascial or intramuscular)
* For needle biopsy soft tissue, use 20206

Codes are out of numerical sequence; see 25066-25078
Code is out of numerical sequence; see 25066-25078

Excision, soft tissue of forearm and/or wrist area

Subcutaneous
- less than 3 cm
- 3 cm or greater
  - For excision of benign lesions of cutaneous origin (e.g., sebaceous cyst), see 11400-11406
Subfascial (e.g., intramuscular)
- less than 3 cm
- 3 cm or greater
Radical resection of tumor (e.g., sarcoma), soft tissue of forearm and/or wrist area.
- less than 3 cm
- 3 cm or greater
  - For radical resection of tumor[s] of cutaneous origin (e.g., melanoma), see 11600-11606
25100: Capsulotomy, wrist (e.g., contracture).

Arthrotomy - wrist joint
* with biopsy.
* with joint exploration, with/without biopsy, removal of loose/foreign body.
* with synovectomy
* Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex

25107: Excision of tendon, forearm and/or wrist, flexor or extensor, each.
25110: Excision, lesion of tendon sheath, forearm and/or wrist.
25111: Excision of ganglion, wrist
* primary.
* recurrent.
* For hand or finger, use 26160.
25115: Radical excision of bursa, synovia of wrist/tendon sheaths (e.g., tenosynovitis, fungus), flexors.
25116: Radical excision of bursa, synovia of wrist/tendon sheaths (e.g., tenosynovitis, fungus), extensors, w/wo transposition of dorsal retinaculum. * For finger synovectomies, use 26145.
- 25118: Synovectomy, extensor tendon sheath, wrist, single compartment.
  - with resection of distal ulna.
  - Excision or curettage of bone cyst or benign tumor of: radius or ulna (excluding head or neck of radius & olecranon process).
  - For head or neck of radius or olecranon process, see 24120-24126.
25125: with autograft (includes obtaining graft).
25126: with allograft.
- Excision or curettage of bone cyst or benign tumor of: carpal bones.
25135: with autograft (includes obtaining graft).
25136: with allograft.
- 25145: Sequestrectomy (e.g., for osteomyelitis or bone abscess), forearm and/or wrist.
- 25150: Partial excision (craterization, saucerization, or diaphysectomy) of bone (e.g., for osteomyelitis)
  - ulna.
  - radius.
    - For head or neck of radius or olecranon process, see 24145, 24147.
25170: Resection of tumor, radius or ulna.
25210: Carpectomy, one bone.
For carpectomy with implant, see 25441-25445
25215: all bones of proximal row.
25230: Radial styloidectomy (separate procedure).
Resection
25240: Resection partial or complete (e.g., Darrach type or matched resection), distal ulna.
*For implant replacement, distal ulna, use 25442
*For obtaining fascia for interposition, see 20920, 20922

Introduction or Removal

*(For K-wire, pin or rod insertion or removal, see 20650, 20670, 20680)

25246: Injection procedure for wrist arthrography.
For radiological supervision and interpretation, use 73115. Do not report 77002 in conjunction with 73115
*For foreign body removal, superficial use 20520
25248: exploration with removal of deep foreign body with exploration, forearm and/or wrist.
25250: Removal of wrist prosthesis (separate procedure).
25251: Removal of wrist implant, including total wrist.

Repair, Revision, and/or Reconstruction

25260: Manipulation, wrist, under anesthesia.
For application of external fixation, refer to codes 20690 or 20692.
25263: Repair, tendon or muscle, forearm or wrist, flexor or extensor; primary, each tendon or muscle.
25264: secondary, each tendon or muscle.
25265: secondary, with free graft (includes obtaining graft), each tendon or muscle.
25270: Repair, tendon or muscle, forearm or wrist, flexor, primary, each tendon or muscle.
25272: secondary, each tendon or muscle.
25274: secondary, with free graft (includes obtaining graft), each tendon or muscle.
25275: Repair, tendon sheath, forearm and/or wrist, with free graft includes (obtaining graft) (e.g., flexor carpi ulnaris subluxation).
25290: Lengthening or shortening of flexor or extensor tendon; forearm and/or wrist, each tendon.
25295: Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon.
25300: Tenolysis, flexor or extensor tendon, forearm and/or wrist, each tendon.
25301: Tenodesis at wrist;
- of finger(s).
  - limitation of motion of finger(s);
- extensors of fingers
25310: Tendon transplantation, flexor or extensor, forearm and/or wrist.
- not report with 25447 25448 when performed for intercarpal or carpometacarpal joint
25312: with tendon graft(s) (includes obtaining graft), each tendon.
- Flexor origin slide
- Flexor origin slide (e.g., for cerebral palsy, Volkmann contracture), forearm and/or wrist.
25320: with tendon(s) transfer
25332: Capsulorrhaphy or reconstruction, wrist, (e.g., capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability.
25335: Arthroplasty, wrist, with or without interposition, with or without external or internal fixation For obtaining fascia for interposition, see 20920, 20922
For prosthetic replacement arthroplasty, see 25441–25446
25335: Centralization of wrist on ulna (e.g., radial club hand).
25337: Reconstruction for stabilization of unstable distal radioulnar joint, by soft tissue stabilization (e.g., tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint.

Resequenced code; see 20526-20529

25350: Osteotomy; radius.
25355: middle or proximal third.
25392: Osteotomy, ulna.
25393: radius.
25394: ulna.
25400: Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure), radius and/or ulna.
25405: radius AND ulna.
25415: Osteoplasty, radius or ulna, shortening.
25420: lengthening with autograft.
25425: Osteoplasty, radius AND ulna, shortening (excluding 64876).
25426: lengthening with autograft.
25430: Repair of nonunion or malunion, radius or ulna; without graft (e.g., compression technique).
25431: with autograft (includes obtaining graft).
25435: Repair of nonunion or malunion, radius AND ulna; without graft (e.g., compression technique).
25436: with autograft (includes obtaining graft).
25440: Repair of defect with autograft; radius or ulna.
25431: radius AND ulna.
25441: Insertion of vascular pedicle into carpal bone (e.g., Hori procedure).

Repair of nonunion of carpal bone

(excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone

25440: Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial stylotdectomy (includes obtaining graft and necessary fixation)

Arthroplasty, prosthetic replacement

25441: distal radius., Aug 17*8-9
25442: distal ulna.,Aug 17*8-9
25443: scaphoid carpal (navicular)..Aug 17*8-9
25444: lunate.,Aug 17*8-9
25445: trapezium.,Aug 17*8-9
25446: partial or entire carpus (total wrist).,Aug 17*8-9
25447: Intercarpal/carpometacarpal joint replacement Arthroplasty, intercarpal or carpometacarpal, with interposition including, tendon
Do not report with 25310. 26480,when performed for intercarpal or carpometacarpal joint
For wrist arthroplastv, use 25332
25448 Arthroplasty, intercarpal/carpometacarpal joint replacement: with expansion
suspension including transfer or transplant and interposition, when performed
Do not report 25448 in coniunction wub 75310 76480,when performed lor intercarpal or carpometacarpal joint
of arthroplasty, including removal of implant
**25449 **of arthroplasty, including
wrist joint. arthrodesis with epiphyseal arrest
25150: distal radius.
25455: ulna.
25490: distal radius AND ulna.
25492: Prophylactic treatment (nailing, pinning, plating or wiring) With or-w11houl methylmothacrylate . 7.4\ ** 25491** radius , 7.4\ ulna, 7.4\ radius ulna , 7.4\ radius ,7.4\ ulna7.4\
With or-"