CPT code 25130: Wrist bone lesion, without bone graft2026 Medicare rate & RVUs in Missouri
Reports operative removal or curettage of a cyst or benign tumor in a carpal bone when the procedure does not include bone grafting.
CMS doesn’t publish an office rate for 25130 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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What 25130 covers
An orthopedic surgeon uses this service to remove or curette a cyst or benign tumor arising in a carpal bone. It describes treatment of the bone lesion itself, rather than removal of a wrist tendon-sheath mass or a lesion in the radius or ulna. The procedure is generally performed in an operating room, with the excised material available for pathologic examination when indicated.
Choose the code when the operative report identifies the carpal bone treated and documents excision or curettage without grafting. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others. For bilateral reporting with modifier 50, CMS pays 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 25130 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 | $416.65 |
| Metropolitan St. Louis, MO | Unavailable | $420.36 |
| Rest of Missouri | Unavailable | $399.57 |
How the 25130 rate is calculated
Each of 25130’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 · 25130
RVUs × geographic indexes × conversion factor
Work5.29
5.29 RVUs× 1.000 GPCI
Practice expense6.60
6.60 RVUs× 1.000 GPCI
Malpractice1.01
1.01 RVUs× 1.000 GPCI
Adjusted RVUs
12.9000
Conversion factor
$33.4009
Medicare rate
$430.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25130
25130 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25130
Wrist bone lesion, without bone graft
| 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 · 25130
Wrist bone lesion, without bone graft
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
25130 without 50 · national facility
$430.87
Wrist bone lesion, without bone graft
25130-50 · Bilateral: 150%
$646.31
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).
25130 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 25120Bone lesion removalRadius or ulna, without graft
- Select 25130 for a lesion in a carpal bone; 25120 addresses a bone lesion in the radius or ulna.
- 25135Bone lesion surgeryCarpal bone, autograft
- This code is for carpal bone lesion removal or curettage without grafting. Compare 25135 when bone grafting is part of the wrist procedure.
- 25136Wrist bone lesionWith allograft
- Use 25130 when the procedure does not include grafting. Consider 25136 when grafting is performed and the code's grafting criteria are met.
- 25110Lesion excisionTendon sheath or capsule
- 25110 concerns a wrist tendon lesion, not a lesion arising within a carpal bone.
25130 billing questions
How is this different from removing a wrist tendon lesion?
This code is for a lesion within a carpal bone. Codes 25110 and 25111 concern tendon-related lesions, so the operative note should establish which structure contains the lesion.
When should a grafted wrist bone-lesion code be considered?
Use 25130 for removal or curettage without bone grafting. When grafting is part of the procedure, compare the applicable grafted wrist-lesion code, 25135 or 25136.
What should the operative report document?
Document the carpal bone involved, the lesion treated, and whether the surgeon excised or curetted it. Record graft use when applicable, since it may change the code selection.
How does CMS handle bilateral reporting and multiple procedures?
With modifier 50, CMS pays this bilateral procedure at 150%. For multiple procedures in one session, CMS pays the highest-valued procedure in full and applies the standard reduction to the others.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or another surgeon be paid for this operation?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.
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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