Basics of CPT code 25447 & 25448
In Musculosketetal, their is one new CPT code added in 2025, CPT code 25448 was added in this section in new year with revision of CPT code 26447. Below is the code description for both the codes.
25447 – Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)
25448 – Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed
The physician performs interposition or suspension arthroplasty on the intercarpal or carpometacarpal joints. For interposition arthroplasty (CPT code 25447) of a non-thumb joint, the physician makes an incision over the carpometacarpal joint. The joint capsule is vertically incised to allow for the release of the joint. The joint is fully dislocated to expose the surface of the proximal metacarpal or distal carpal bone. The physician then removes the proximal metacarpal or distal carpal bone, reshaping the base to accommodate a metacarpal prosthesis. A soft tissue graft, typically a harvested tendon or fascia, is used to replace the excised bone. A Kirschner wire may be inserted for temporary joint stabilization, and the capsule and incision sites are sutured closed.
For interposition arthroplasty on a thumb joint, the physician makes an incision over the upper third of the first metacarpal, extending to the trapezioscaphoid joint. The covering muscles and joint capsules are incised, and the trapezium, and possibly the base of the first metacarpal, are removed. The resulting defect is filled with soft tissue, typically a tendon or fascia graft. A Kirschner wire may be used for temporary stabilization, and the capsule and wound are sutured closed. This procedure is commonly known as ligament reconstruction and tendon interposition (LRTI).
In suspension arthroplasty (CPT code 25448), the physician creates a bone tunnel at the base of the first metacarpal. The flexor carpi radialis tendon is dissected at the base of the second metacarpal, then passed through the tunnel in the first metacarpal and secured with sutures. The capsule and wound are then sutured closed. This code also includes tendon transfer or transplant with interposition, if performed.
CPT code 25448 & 25447 should not be reported together. Only code code can be reported at a time.