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CPT code 25126: Bone lesion surgery, radius or ulna, with allograft2026 Medicare rate & RVUs

Reports curettage or excision of a benign bone lesion in the radius or ulna when the resulting defect is filled with allograft.

CMS RVU26DEffective Oct 1, 2026109 payment localities33 Medicare services in 2024

Medicare pays $574.50 for 25126 nationally in a facility.

Medicare rate · 25126

Bone lesion surgery, radius or ulna, with allograft

Office or facility?

Work RVUs
7.55
Total RVUs
17.20
Global days
090

National rate · 2026

$574.50

Facility setting, before claim adjustments.

See every locality for 25126 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 25126 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 25126 covers

This procedure treats a bone cyst or benign tumor in the radius or ulna by removing or curetting the lesion and filling the resulting bone defect with donor bone graft. An orthopedic or hand surgeon typically performs it in an operating room. The operative report should identify the affected bone, describe the lesion removal, and document that allograft was used to fill the defect.

Select this code for the radius or ulna when allograft is used; the no-graft and autograft versions are separate codes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery may be 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.

Where 25126 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

25126 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$517.59
AlaskaUnavailable$693.89
ArizonaUnavailable$558.43
ArkansasUnavailable$510.55
Atlanta, GAUnavailable$590.36
Austin, TXUnavailable$584.44
Bakersfield, CAUnavailable$584.04
Baltimore area, MDUnavailable$610.88
Beaumont, TXUnavailable$546.51
Brazoria, TXUnavailable$562.27

25126 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
25126 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 25126 rate is calculated

Each of 25126’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 · 25126

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.55

7.55 RVUs× 1.000 GPCI

Practice expense8.04

8.04 RVUs× 1.000 GPCI

Malpractice1.61

1.61 RVUs× 1.000 GPCI

Adjusted RVUs

17.2000

Conversion factor

$33.4009

Medicare rate

$574.50

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 25126

25126 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25126

Bone lesion surgery, radius or ulna, with allograft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25126

Bone lesion surgery, radius or ulna, with allograft

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25126 without 50 · national facility

$574.50

Bone lesion surgery, radius or ulna, with allograft

25126-50 · Bilateral: 150%

$861.75

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).

When to use modifier 50

25126 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 25126

    Bone lesion surgery, radius or ulna, with allograft7.55 wRVU

    Not priced

  • 25120

    Bone lesion removal, radius or ulna, without graft6.11 wRVU

    Not priced

  • 25125

    Bone lesion excision, forearm, with autograft7.48 wRVU

    Not priced

  • 25135

    Bone lesion surgery, carpal bone, autograft6.9 wRVU

    Not priced

How to choose

25120Bone lesion removalRadius or ulna, without graft
Both address qualifying bone lesions of the radius or ulna, but 25120 is for treatment without graft; 25126 includes allograft.
25125Bone lesion excisionForearm, with autograft
Both include grafting after radius-or-ulna lesion treatment. Choose 25125 for autograft and 25126 for allograft.
25135Bone lesion surgeryCarpal bone, autograft
This code concerns a carpal bone and autograft, while 25126 concerns the radius or ulna and allograft.

Codes related to 25126

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 25126
CodeHow it relatesNational office range
Same family
25120Bone lesion removal, radius or ulna, without graftForearm radius-or-ulna lesion treatment without graft.No office rate
25125Bone lesion excision, forearm, with autograftForearm radius-or-ulna lesion treatment using autograft instead of allograft.No office rate
Used instead
25135Bone lesion surgery, carpal bone, autograftGraft-based lesion treatment for a carpal bone rather than the radius or ulna.No office rate

25126 billing questions

How does this differ from 25125?

Use 25126 when the defect is filled with allograft. Code 25125 describes the corresponding procedure using autograft.

When is 25120 more appropriate?

Use 25120 for qualifying lesion removal or curettage in the radius or ulna when no graft is used. Code 25126 includes allograft use.

What documentation supports 25126?

Document the radius or ulna involved, the bone cyst or benign tumor treatment, and use of allograft to fill the defect.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other same-session procedures paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS pays bilateral reporting with modifier 50 at 150%.

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
RVUs for 25126PPRRVU2026_Oct_nonQPP.csv, line 2,401 (RVU26D)

Open CMS sourceHow we calculate rates

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