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Billing code 25001: Tendon sheath incisionMedicare rate & RVUs

Reports operative opening of the flexor carpi radialis tendon sheath at the wrist, typically to treat focal tendon-sheath disease such as tenosynovitis.

CMS RVU26DEffective Oct 1, 2026109 payment localities162 Medicare services in 2024

Medicare pays $341.36 for 25001 nationally in a facility.

Medicare rate · 25001

Tendon sheath incision

Swap in your local Medicare rate.

Work RVUs
3.7
Total RVUs
10.22
Global days
090

National rate · 2026

$341.36

Facility setting, before claim adjustments.

See every locality for 25001 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 25001 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 25001 covers

This operation opens the tendon sheath surrounding the flexor carpi radialis (FCR) at the wrist to relieve a constricting or diseased sheath. Hand and orthopedic surgeons commonly perform it for symptomatic FCR tenosynovitis or stenosis, often in an operating room at a hospital or ambulatory surgery center. The target is the FCR sheath, not the extensor tendons or a forearm fascial compartment.

Report the code when the operative service is an incision of the FCR tendon sheath. The operative note should identify the involved tendon and side, describe the sheath incision and the clinical finding being treated, and distinguish the work from a broader synovectomy or another wrist procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this code; 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 25001 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

25001 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$307.01
Alaska*Unavailable$405.46
ArizonaUnavailable$332.00
ArkansasUnavailable$302.72
AtlantaUnavailable$349.48
AustinUnavailable$350.27
BakersfieldUnavailable$353.39
Baltimore/Surr. CntysUnavailable$363.01
BeaumontUnavailable$322.20
BrazoriaUnavailable$335.52

25001 rates by state

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

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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
25001 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 25001 rate is calculated

Each of 25001’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 · 25001

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.70Practice expense 5.83Malpractice 0.69

10.2200 adjusted RVUs×$33.4009 conversion factor=$341.36

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25001

25001 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25001

Tendon sheath incision

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)1Not paid (statutory restriction).
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 · 25001

Tendon sheath incision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

25001 without 50 · national facility

$341.36

Tendon sheath incision

25001-50 · Bilateral: 150%

$512.04

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

25001 compared with similar codes

Compare codes

25001 vs 25000 vs 25115 vs 25020: national Medicare rates

Swap in your local Medicare rate.

  • 25001
    Tendon sheath incision · 3.7 wRVU
    —
  • 25000
    Tendon release · 3.46 wRVU
    —
  • 25115
    Lesion excision · 9.84 wRVU
    —
  • 25020
    Forearm fasciotomy · 5.91 wRVU
    —

How to choose

25000Tendon release
Choose 25001 for incision of the FCR sheath. Choose 25000 for the specified extensor tendon-sheath incision at the wrist.
25115Lesion excision
25115 describes wrist flexor tendon-sheath synovectomy. Use 25001 when the documented work is incision of the FCR sheath rather than synovectomy.
25020Forearm fasciotomy
25020 is a forearm decompression procedure involving one space. It is not an incision of the FCR tendon sheath at the wrist.

Codes related to 25001

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

Codes related to 25001
CodeHow it relatesNational office range
Same family
25000Tendon releaseRelated wrist tendon-sheath incision, but for an extensor rather than the FCR sheath.No office rate
Used instead
25115Lesion excisionWrist flexor tendon-sheath synovectomy when synovectomy, rather than sheath incision, is performed.No office rate
25118Tendon sheath excisionWrist extensor tendon-sheath synovectomy, a different target and procedure.No office rate

25001 billing questions

How is this different from 25000?

This code is for opening the flexor carpi radialis tendon sheath. Code 25000 addresses an extensor tendon sheath at the wrist, such as the sheath involved in De Quervain disease.

When would a synovectomy code be more appropriate?

Consider 25115 when the documented work is synovectomy of a wrist flexor tendon sheath rather than an incision of the FCR sheath alone. The operative report should support the actual procedure performed.

What documentation supports reporting this code?

Document the FCR as the treated tendon, the side, the sheath pathology or constriction, and the incision or release performed. The note should make clear that the service was not an extensor-sheath procedure or forearm compartment decompression.

Can this code be reported bilaterally?

Yes. CMS specifies modifier 50 for bilateral performance, with payment at 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are paid at 50%. The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care.

Can an assistant or co-surgeon be billed for this procedure?

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
RVUs for 25001PPRRVU2026_Oct_nonQPP.csv, line 2,369 (RVU26D)

Open CMS sourceHow we calculate rates

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