CPT code 25118: Tendon sheath excision, wrist tenosynovectomy2026 Medicare rate & RVUs in New Mexico
Reports surgical removal of diseased wrist tendon sheath tissue, commonly for persistent tenosynovitis when the operative target is the sheath rather than the tendon or joint.
In New Mexico, Medicare pays $359.23 for 25118 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 25118 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 25118 covers
A hand or orthopedic surgeon removes abnormal synovial tissue from around wrist tendons, as in a tenosynovectomy for persistent inflammatory or proliferative tenosynovitis. A typical clinical setting is surgery for wrist tendon-sheath disease, including disease associated with rheumatoid arthritis. The operative target is the tendon sheath and its diseased lining, not the tendon itself or the wrist joint lining.
Report the code when the documented procedure excises wrist tendon sheath tissue; a discrete cyst or other focal lesion may instead point to a lesion-excision code. The operative report should identify the wrist, the involved sheath or tendon compartment, the condition treated, and the tissue removed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.
How New Mexico compares for 25118
Across 109 of 109 payment localities, the facility rate for 25118 runs from $328.68 in Arkansas to $458.97 in San Benito County, CA. New Mexico pays $359.23. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$359.23
- Los Angeles, CA · California$401.98+$42.75
- Washington, DC area · District of Columbia$415.52+$56.29
- Miami, FL · Florida$420.63+$61.40
- Chicago, IL · Illinois$408.08+$48.85
- Manhattan, NY · New York$427.14+$67.91
- Alaska · Alaska$443.29+$84.06
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $333.23 |
| ArkansasArkansas | — | $328.68 |
| ArizonaArizona | — | $359.67 |
| Bakersfield, CACalifornia | — | $380.26 |
| Chico, CACalifornia | — | $377.92 |
| El Centro, CACalifornia | — | $378.06 |
| Fresno, CACalifornia | — | $377.92 |
| Hanford, CACalifornia | — | $377.92 |
| Madera, CACalifornia | — | $377.92 |
| Merced, CACalifornia | — | $377.92 |
| Modesto, CACalifornia | — | $377.92 |
| Napa, CACalifornia | — | $427.13 |
| Oxnard, CACalifornia | — | $398.73 |
| Redding, CACalifornia | — | $377.92 |
| Rest of CaliforniaCalifornia | — | $377.92 |
| Riverside, CACalifornia | — | $386.96 |
| Sacramento, CACalifornia | — | $393.76 |
| Salinas, CACalifornia | — | $392.25 |
| San Diego, CACalifornia | — | $399.47 |
| Marin County, CACalifornia | — | $448.37 |
| San Francisco, CACalifornia | — | $447.42 |
| San Benito County, CACalifornia | — | $458.97 |
| Santa Clara County, CACalifornia | — | $455.07 |
| San Luis Obispo, CACalifornia | — | $386.30 |
| Santa Cruz, CACalifornia | — | $401.68 |
| Santa Maria, CACalifornia | — | $393.17 |
| Santa Rosa, CACalifornia | — | $405.54 |
| Stockton, CACalifornia | — | $377.92 |
| Vallejo, CACalifornia | — | $425.75 |
| Visalia, CACalifornia | — | $377.92 |
| Yuba City, CACalifornia | — | $377.92 |
| ColoradoColorado | — | $377.83 |
| ConnecticutConnecticut | — | $393.57 |
| DelawareDelaware | — | $365.31 |
| Fort Lauderdale, FLFlorida | — | $394.95 |
| Rest of FloridaFlorida | — | $375.29 |
| Atlanta, GAGeorgia | — | $378.94 |
| Rest of GeorgiaGeorgia | — | $354.10 |
| Hawaii, Guam, HIHawaii | — | $384.61 |
| IowaIowa | — | $336.28 |
| IdahoIdaho | — | $339.38 |
| East St. Louis, ILIllinois | — | $382.62 |
| Rest of IllinoisIllinois | — | $368.60 |
| Suburban Chicago, ILIllinois | — | $397.69 |
| IndianaIndiana | — | $341.11 |
| KansasKansas | — | $337.14 |
| KentuckyKentucky | — | $345.75 |
| New Orleans, LALouisiana | — | $362.07 |
| Rest of LouisianaLouisiana | — | $346.18 |
| Metropolitan Boston, MAMassachusetts | — | $410.46 |
| Rest of MassachusettsMassachusetts | — | $376.72 |
| Baltimore area, MDMaryland | — | $392.96 |
| Rest of MarylandMaryland | — | $371.25 |
| Rest of MaineMaine | — | $343.56 |
| Southern Maine, MEMaine | — | $357.64 |
| Detroit, MIMichigan | — | $382.18 |
| Rest of MichiganMichigan | — | $356.43 |
| MinnesotaMinnesota | — | $355.64 |
| Metropolitan Kansas City, MOMissouri | — | $357.22 |
| Metropolitan St. Louis, MOMissouri | — | $360.46 |
| Rest of MissouriMissouri | — | $342.15 |
| MississippiMississippi | — | $335.36 |
| MontanaMontana | — | $369.69 |
| North CarolinaNorth Carolina | — | $346.57 |
| North DakotaNorth Dakota | — | $353.08 |
| NebraskaNebraska | — | $337.30 |
| New HampshireNew Hampshire | — | $374.22 |
| Northern New JerseyNew Jersey | — | $412.07 |
| Rest of New JerseyNew Jersey | — | $396.26 |
| NevadaNevada | — | $365.26 |
| NYC suburbs and Long Island, NYNew York | — | $440.00 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $400.75 |
| Queens, NYNew York | — | $427.00 |
| Rest of New YorkNew York | — | $351.68 |
| OhioOhio | — | $353.03 |
| OklahomaOklahoma | — | $342.66 |
| Portland, OROregon | — | $386.53 |
| Rest of OregonOregon | — | $360.64 |
| Metropolitan Philadelphia, PAPennsylvania | — | $385.79 |
| Rest of PennsylvaniaPennsylvania | — | $352.24 |
| Puerto RicoPuerto Rico | — | $371.47 |
| Rhode IslandRhode Island | — | $375.94 |
| South CarolinaSouth Carolina | — | $350.74 |
| South DakotaSouth Dakota | — | $351.12 |
| TennesseeTennessee | — | $339.04 |
| Austin, TXTexas | — | $378.14 |
| Beaumont, TXTexas | — | $350.23 |
| Brazoria, TXTexas | — | $363.00 |
| Dallas, TXTexas | — | $366.31 |
| Fort Worth, TXTexas | — | $364.73 |
| Galveston, TXTexas | — | $364.73 |
| Houston, TXTexas | — | $380.11 |
| Rest of TexasTexas | — | $357.10 |
| UtahUtah | — | $355.20 |
| VirginiaVirginia | — | $358.19 |
| Virgin Islands, VIUnited States Virgin Islands | — | $371.47 |
| VermontVermont | — | $353.94 |
| Rest of WashingtonWashington | — | $375.27 |
| King County, WAWashington | — | $416.16 |
| WisconsinWisconsin | — | $342.15 |
| West VirginiaWest Virginia | — | $356.33 |
| WyomingWyoming | — | $362.45 |
25118 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 25118 rate is calculated
Each of 25118’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 · 25118
RVUs × geographic indexes × conversion factor
Work4.40
4.40 RVUs× 1.000 GPCI
Practice expense5.83
5.83 RVUs× 1.000 GPCI
Malpractice0.84
0.84 RVUs× 1.000 GPCI
Adjusted RVUs
11.0700
Conversion factor
$33.4009
Medicare rate
$369.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,397
- Code
- 25118
- Physician work
- 4.40
- Practice expense
- 5.83
- Malpractice
- 0.84
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.40 | × 1.000 | 4.4000 |
| Practice expense | 5.83 | × 0.917 | 5.3461 |
| Malpractice | 0.84 | × 1.201 | 1.0088 |
| Total RVUs | 10.7550 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$359.23
Facility: (4.4 × 1 + 5.83 × 0.917 + 0.84 × 1.201) × $33.4009 = $359.23
Payment rules and modifiers for 25118
25118 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25118
Tendon sheath excision, wrist tenosynovectomy
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 25118
Tendon sheath excision, wrist tenosynovectomy
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
25118 without 50 · national facility
$369.75
Tendon sheath excision, wrist tenosynovectomy
25118-50 · Bilateral: 150%
$554.63
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).
How 25118 has changed in New Mexico
25118 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $359.23 | RVU26D |
| 2026-07-01 | Not available in this setting | $359.23 | RVU26C |
| 2026-04-01 | Not available in this setting | $359.23 | RVU26B |
| 2026-01-01 | Not available in this setting | $359.23 | RVU26A |
| 2025-10-01 | Not available in this setting | $370.90 | RVU25D |
| 2025-07-01 | Not available in this setting | $370.90 | RVU25C |
| 2025-04-01 | Not available in this setting | $370.90 | RVU25B |
| 2025-01-01 | Not available in this setting | $370.90 | RVU25A |
| 2024-10-01 | Not available in this setting | $377.94 | RVU24D |
| 2024-07-01 | Not available in this setting | $377.94 | RVU24C |
| 2024-04-01 | Not available in this setting | $377.94 | RVU24B |
| 2024-03-09 | Not available in this setting | $377.94 | RVU24AR |
| 2024-01-01 | Not available in this setting | $371.77 | RVU24A |
| 2023-10-01 | Not available in this setting | $378.19 | RVU23D |
| 2023-07-01 | Not available in this setting | $378.19 | RVU23C |
| 2023-04-01 | Not available in this setting | $378.19 | RVU23B |
| 2023-01-01 | Not available in this setting | $378.19 | RVU23A |
| 2022-10-01 | Not available in this setting | $378.49 | RVU22D |
| 2022-07-01 | Not available in this setting | $378.49 | RVU22C |
| 2022-04-01 | Not available in this setting | $378.49 | RVU22B |
| 2022-01-01 | Not available in this setting | $378.49 | RVU22A |
| 2021-10-01 | Not available in this setting | $377.09 | RVU21D |
| 2021-07-01 | Not available in this setting | $377.09 | RVU21C |
| 2021-04-01 | Not available in this setting | $377.09 | RVU21B |
| 2021-01-01 | Not available in this setting | $377.09 | RVU21A |
| 2020-10-01 | Not available in this setting | $382.65 | RVU20D |
| 2020-07-01 | Not available in this setting | $382.65 | RVU20C |
| 2020-04-01 | Not available in this setting | $382.65 | RVU20B |
| 2020-01-01 | Not available in this setting | $382.65 | RVU20A |
| 2019-10-01 | Not available in this setting | $385.48 | RVU19D |
| 2019-07-01 | Not available in this setting | $385.48 | RVU19C |
| 2019-04-01 | Not available in this setting | $385.48 | RVU19B |
| 2019-01-01 | Not available in this setting | $385.48 | RVU19A |
| 2018-10-01 | Not available in this setting | $385.50 | RVU18D |
| 2018-07-01 | Not available in this setting | $385.50 | RVU18C |
| 2018-04-01 | Not available in this setting | $385.50 | RVU18B |
| 2018-01-01 | Not available in this setting | $385.50 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $381.63 | RVU17D |
| 2017-07-01 | Not available in this setting | $381.63 | RVU17C |
| 2017-04-01 | Not available in this setting | $381.63 | RVU17B |
| 2017-01-01 | Not available in this setting | $381.63 | RVU17A |
| 2016-10-01 | Not available in this setting | $379.01 | RVU16D |
| 2016-07-01 | Not available in this setting | $379.01 | RVU16C |
| 2016-04-01 | Not available in this setting | $379.01 | RVU16B |
| 2016-01-01 | Not available in this setting | $379.01 | RVU16A |
| 2015-10-01 | Not available in this setting | $379.63 | RVU15D |
| 2015-07-01 | Not available in this setting | $379.63 | RVU15C |
| 2015-04-01 | Not available in this setting | $377.74 | RVU15B |
| 2015-01-01 | Not available in this setting | $377.74 | RVU15A |
| 2014-10-01 | Not available in this setting | $371.86 | RVU14D |
| 2014-07-01 | Not available in this setting | $371.86 | RVU14C |
| 2014-04-01 | Not available in this setting | $371.86 | RVU14B |
| 2014-01-01 | Not available in this setting | $371.86 | RVU14A |
| 2013-10-01 | Not available in this setting | $368.19 | RVU13D |
| 2013-07-01 | Not available in this setting | $368.19 | RVU13C |
| 2013-04-01 | Not available in this setting | $368.19 | RVU13B |
| 2013-01-01 | Not available in this setting | $368.19 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
25118 billing questions
When is this code appropriate instead of a tendon lesion excision code?
Use this code for removal of diseased wrist tendon sheath tissue, such as a tenosynovectomy. A discrete cyst or other localized lesion of the sheath may fit a lesion-excision code instead.
How is this different from wrist joint synovectomy?
This procedure removes tissue around wrist tendons. Wrist joint synovectomy addresses the lining inside the joint.
What should the operative note document?
Document the wrist and involved tendon sheath or compartment, the underlying condition, and the sheath tissue excised. The note should make clear that the work involved the sheath rather than the tendon or joint lining.
Does Medicare include related postoperative visits in the payment?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral procedures and other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported for this operation?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
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