CPT code 25125: Bone lesion excision, forearm, with autograft2026 Medicare rate & RVUs in Illinois
Reports removal or curettage of a benign lesion or cyst in the radius or ulna, with the resulting bone defect filled using the patient's own graft.
CMS doesn’t publish an office rate for 25125 in Illinois.
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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What 25125 covers
An orthopedic surgeon removes or curettes a bone cyst or benign tumor in the radius or ulna and fills the defect with the patient's own bone graft. The procedure is performed in an operative setting when the lesion requires surgical treatment and grafting to address the bone defect. The operative report should identify the affected forearm bone, the lesion treated, the excision or curettage, and the autograft used; this code includes obtaining the graft.
Select this service when the forearm bone lesion is treated with autograft, rather than reporting the corresponding excision or curettage without graft. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and other procedures at 50%. For bilateral reporting with modifier 50, CMS pays 150%. An assistant at surgery is paid only when medical necessity is documented; 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 25125 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $642.68 |
| East St. Louis, IL | Unavailable | $603.24 |
| Rest of Illinois | Unavailable | $577.42 |
| Suburban Chicago, IL | Unavailable | $620.80 |
How the 25125 rate is calculated
Each of 25125’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 · 25125
RVUs × geographic indexes × conversion factor
Work7.48
7.48 RVUs× 1.000 GPCI
Practice expense8.02
8.02 RVUs× 1.000 GPCI
Malpractice1.59
1.59 RVUs× 1.000 GPCI
Adjusted RVUs
17.0900
Conversion factor
$33.4009
Medicare rate
$570.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25125
25125 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25125
Bone lesion excision, forearm, with autograft
| 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 · 25125
Bone lesion excision, forearm, with autograft
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
25125 without 50 · national facility
$570.82
Bone lesion excision, forearm, with autograft
25125-50 · Bilateral: 150%
$856.23
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).
25125 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25120Bone lesion removalRadius or ulna, without graft
- Both address a cyst or benign tumor in the radius or ulna. Choose 25125 when autograft is used to fill the defect; 25120 describes treatment without graft.
- 25126Bone lesion surgeryRadius or ulna, with allograft
- The graft source distinguishes these related forearm procedures: 25125 uses the patient's own bone, while 25126 uses allograft.
- 25135Bone lesion surgeryCarpal bone, autograft
- This related grafted lesion procedure applies to a wrist bone. Use 25125 for a lesion in the radius or ulna.
25125 billing questions
How does this differ from 25120?
Use 25125 when the radius or ulna lesion is removed or curetted and the defect is filled with autograft. Code 25120 describes the corresponding treatment without graft.
Is graft harvesting separately reported?
No. Obtaining the autograft is included in this service.
How does 25126 differ?
Code 25126 is the related forearm lesion procedure using allograft. This code is for treatment with the patient's own bone.
What documentation supports the code?
Document whether the lesion is in the radius or ulna, the removal or curettage performed, and that the defect was filled with autograft.
Can modifier 50 be used for bilateral procedures?
CMS identifies this as a bilateral procedure. With modifier 50, payment is 150%.
Can an assistant surgeon be reported?
CMS pays an assistant at surgery only when medical necessity is documented. 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
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