CPT code 25116: Tumor resection, soft tissue under 5 cm2026 Medicare rate & RVUs in Florida
Reports radical removal of a soft-tissue tumor in the forearm or wrist when the tumor measures less than 5 cm.
CMS doesn’t publish an office rate for 25116 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 25116 covers
This code covers radical resection of a soft-tissue tumor in the forearm or wrist measuring less than 5 cm. The surgeon removes the tumor with the surrounding tissue needed for the planned resection, rather than simply removing a superficial lump or dissecting a tendon-sheath cyst. Orthopedic and hand surgeons commonly perform the procedure in an operating room when a soft-tissue tumor requires this extent of excision.
Choose the code based on the tumor’s size and the documented scope of resection; the operative report should identify the forearm or wrist site, tumor dimensions, and tissues removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity, and co-surgeon payment requires supporting documentation. Team surgery is 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 25116 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $612.82 |
| Miami, FL | Unavailable | $654.56 |
| Rest of Florida | Unavailable | $582.62 |
How the 25116 rate is calculated
Each of 25116’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 · 25116
RVUs × geographic indexes × conversion factor
Work7.37
7.37 RVUs× 1.000 GPCI
Practice expense8.32
8.32 RVUs× 1.000 GPCI
Malpractice1.41
1.41 RVUs× 1.000 GPCI
Adjusted RVUs
17.1000
Conversion factor
$33.4009
Medicare rate
$571.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25116
25116 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25116
Tumor resection, soft tissue under 5 cm
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 25116
Tumor resection, soft tissue under 5 cm
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
25116 without 50 · national facility
$571.16
Tumor resection, soft tissue under 5 cm
25116-50 · Bilateral: 150%
$856.74
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).
25116 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 25115Lesion excisionWrist or forearm
- Both codes describe radical resection of a forearm or wrist soft-tissue tumor. Select 25116 for a tumor under 5 cm and 25115 for the larger-size category.
- 25110Lesion excisionTendon sheath or capsule
- 25110 is for a lesion involving a tendon sheath or joint capsule, such as a cyst. 25116 describes radical resection of a soft-tissue tumor.
- 25111Wrist ganglion excisionPrimary ganglion
- 25111 is for primary wrist ganglion excision. It is not the code for radical resection of a soft-tissue tumor.
- 25120Bone lesion removalRadius or ulna, without graft
- 25120 addresses a bone cyst or benign tumor of the radius or ulna. 25116 concerns soft tissue in the forearm or wrist.
25116 billing questions
How does this differ from 25115?
These codes distinguish radical soft-tissue tumor resections by size. Use 25116 for a tumor under 5 cm; 25115 is the larger-size sibling.
Can this code be used for a wrist ganglion?
A routine wrist ganglion excision is not the same service as radical tumor resection. Use the ganglion code when that is the procedure performed and documented.
What documentation supports this code?
Document the forearm or wrist location, tumor dimensions, and the extent of tissue resected. The operative report should support radical resection rather than a limited or superficial excision.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
How are bilateral procedures and multiple procedures paid?
When reported bilaterally with modifier 50, CMS pays at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
Fee sheets · Coming soon
Put 25116 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist