CPT code 25101: Wrist arthrotomy, exploration, drainage, or foreign body2026 Medicare rate & RVUs in Missouri
Report open wrist joint exploration, drainage, or foreign body removal when the surgeon enters the joint to evaluate or treat an identified problem.
CMS doesn’t publish an office rate for 25101 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 25101 covers
This service involves opening the wrist joint through an incision so the surgeon can inspect the joint, drain it, or remove a foreign body. It may be performed by an orthopedic or hand surgeon in a hospital or ambulatory surgery setting. The operative report should identify the wrist joint and describe the findings and the work performed, such as the exploration, drainage, or foreign body extraction.
Report this code when the documented procedure matches that open joint work; a biopsy or removal of synovial tissue is a different service. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 25101 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $378.97 |
| Metropolitan St. Louis, MO | Unavailable | $382.39 |
| Rest of Missouri | Unavailable | $363.16 |
How the 25101 rate is calculated
Each of 25101’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 25101
RVUs × geographic indexes × conversion factor
Work4.71
4.71 RVUs× 1.000 GPCI
Practice expense6.11
6.11 RVUs× 1.000 GPCI
Malpractice0.92
0.92 RVUs× 1.000 GPCI
Adjusted RVUs
11.7400
Conversion factor
$33.4009
Medicare rate
$392.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25101
25101 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25101
Wrist arthrotomy, exploration, drainage, or foreign body
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25101
Wrist arthrotomy, exploration, drainage, or foreign body
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25101 without 50 · national facility
$392.13
Wrist arthrotomy, exploration, drainage, or foreign body
25101-50 · Bilateral: 150%
$588.20
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
25101 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25100Wrist biopsyOpen joint approach
- Choose 25100 when the wrist arthrotomy is performed to obtain a joint biopsy. Choose 25101 for exploration, drainage, or foreign body removal instead.
- 25105Wrist synovectomyOpen approach
- 25105 describes wrist joint synovectomy. 25101 applies when the documented work is exploration, drainage, or foreign body removal rather than synovial lining excision.
- 25107Wrist cartilage excisionOpen arthrotomy approach
- 25107 is for removal of wrist joint cartilage. It is not the code for general joint exploration, drainage, or foreign body removal.
25101 billing questions
How does this differ from 25100?
25101 is for open exploration, drainage, or foreign body removal from the wrist joint. Use 25100 when the arthrotomy is performed for a joint biopsy.
When is 25105 more appropriate?
Use 25105 when the surgeon performs a wrist joint synovectomy, removing synovial lining. Exploration or drainage without that synovectomy is the work described by 25101.
What should the operative note document?
Document the wrist joint entered, the reason for the arthrotomy, and whether the surgeon explored the joint, drained it, or removed a foreign body.
How is bilateral surgery reported?
For bilateral wrist procedures, report modifier 50; CMS pays this code at 150% when reported bilaterally.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
How does the multiple-procedure reduction affect payment?
When this procedure is performed with other procedures in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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