No office rate
25100 identifies an open wrist-joint procedure to obtain a diagnostic tissue specimen. 25101 is used when the operative objective is exploration or treatment.
On this page
CMS RVU26D · Effective 2026-10-01
25100 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$354.30
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Orthopedic surgery
About 25100: Open wrist joint biopsy
An open wrist arthrotomy to obtain intra-articular tissue for diagnostic evaluation when a surgeon needs a surgical specimen rather than joint fluid alone.
The surgeon opens the wrist joint and removes a tissue sample for diagnostic evaluation. The specimen may be synovium or other intra-articular tissue submitted for pathologic or microbiologic study when the cause of persistent synovitis, suspected infection, or another joint abnormality remains uncertain. Orthopedic and hand surgeons typically perform this procedure in a hospital operating room or ambulatory surgery center; it is an open surgical biopsy, not needle aspiration or arthroscopic sampling.
Report the code when the operative record supports an open joint approach and tissue was obtained for biopsy. Document the wrist, operative approach, sampled tissue, and diagnostic purpose. CMS 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 payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25100
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.92 · 38%
- Practice expense (office) RVU5.63 · 54%
- Malpractice RVU0.84 · 8%
64
Medicare services in 2024 · #5196 by national volume
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.
25100 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
29840 is a diagnostic arthroscopic wrist procedure, with or without synovial biopsy. Choose 25100 when the biopsy is performed through an open arthrotomy.
$59.36
20605 describes aspiration or injection of an intermediate joint such as the wrist. It involves joint fluid, not an open surgical tissue biopsy.
The same code, a different location
How does Modesto compare?
25100 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Merced
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Napa
California · 25100
Office
Unavailable
Facility
$401.28
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 25100
Office
Unavailable
Facility
$374.35
No comparable office rate is available.
Redding
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Rest Of California
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 25100
Office
Unavailable
Facility
$363.32
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 25100
Office
Unavailable
Facility
$369.38
No comparable office rate is available.
Salinas
California · 25100
Office
Unavailable
Facility
$367.98
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 25100
Office
Unavailable
Facility
$374.97
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 25100
Office
Unavailable
Facility
$421.39
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 25100
Office
Unavailable
Facility
$420.44
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 25100
Office
Unavailable
Facility
$431.54
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 25100
Office
Unavailable
Facility
$427.64
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 25100
Office
Unavailable
Facility
$362.38
No comparable office rate is available.
Santa Cruz-Watsonville
California · 25100
Office
Unavailable
Facility
$377.20
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 25100
Office
Unavailable
Facility
$368.90
No comparable office rate is available.
Santa Rosa-Petaluma
California · 25100
Office
Unavailable
Facility
$380.82
No comparable office rate is available.
Stockton
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Vallejo
California · 25100
Office
Unavailable
Facility
$399.90
No comparable office rate is available.
Visalia
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Yuba City
California · 25100
Office
Unavailable
Facility
$354.30
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 25100
Office
Unavailable
Facility
$390.75
No comparable office rate is available.
Miami
Florida · 25100
Office
Unavailable
Facility
$397.64
No comparable office rate is available.
Chicago
Illinois · 25100
Office
Unavailable
Facility
$385.23
No comparable office rate is available.
Manhattan
New York · 25100
Office
Unavailable
Facility
$402.32
No comparable office rate is available.
Alaska*
Alaska · 25100
Office
Unavailable
Facility
$412.13
No comparable office rate is available.
Alabama
Alabama · 25100
Office
Unavailable
Facility
$311.35
No comparable office rate is available.
Arkansas
Arkansas · 25100
Office
Unavailable
Facility
$306.91
No comparable office rate is available.
Arizona
Arizona · 25100
Office
Unavailable
Facility
$337.17
No comparable office rate is available.
Colorado
Colorado · 25100
Office
Unavailable
Facility
$354.50
No comparable office rate is available.
Connecticut
Connecticut · 25100
Office
Unavailable
Facility
$370.03
No comparable office rate is available.
Delaware
Delaware · 25100
Office
Unavailable
Facility
$342.60
No comparable office rate is available.
Fort Lauderdale
Florida · 25100
Office
Unavailable
Facility
$372.15
No comparable office rate is available.
Rest Of Florida
Florida · 25100
Office
Unavailable
Facility
$352.87
No comparable office rate is available.
Atlanta
Georgia · 25100
Office
Unavailable
Facility
$356.08
No comparable office rate is available.
Rest Of Georgia
Georgia · 25100
Office
Unavailable
Facility
$332.11
No comparable office rate is available.
Hawaii, Guam
Hawaii · 25100
Office
Unavailable
Facility
$360.99
No comparable office rate is available.
Iowa
Iowa · 25100
Office
Unavailable
Facility
$314.13
No comparable office rate is available.
Idaho
Idaho · 25100
Office
Unavailable
Facility
$317.21
No comparable office rate is available.
East St. Louis
Illinois · 25100
Office
Unavailable
Facility
$360.44
No comparable office rate is available.
Rest Of Illinois
Illinois · 25100
Office
Unavailable
Facility
$346.47
No comparable office rate is available.
Suburban Chicago
Illinois · 25100
Office
Unavailable
Facility
$374.69
No comparable office rate is available.
Indiana
Indiana · 25100
Office
Unavailable
Facility
$318.89
No comparable office rate is available.
Kansas
Kansas · 25100
Office
Unavailable
Facility
$315.07
No comparable office rate is available.
Kentucky
Kentucky · 25100
Office
Unavailable
Facility
$323.78
No comparable office rate is available.
New Orleans
Louisiana · 25100
Office
Unavailable
Facility
$339.76
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 25100
Office
Unavailable
Facility
$324.23
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 25100
Office
Unavailable
Facility
$385.80
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 25100
Office
Unavailable
Facility
$353.40
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 25100
Office
Unavailable
Facility
$369.51
No comparable office rate is available.
Rest Of Maryland
Maryland · 25100
Office
Unavailable
Facility
$348.30
No comparable office rate is available.
Rest Of Maine
Maine · 25100
Office
Unavailable
Facility
$321.39
No comparable office rate is available.
Southern Maine
Maine · 25100
Office
Unavailable
Facility
$334.99
No comparable office rate is available.
Detroit
Michigan · 25100
Office
Unavailable
Facility
$359.70
No comparable office rate is available.
Rest Of Michigan
Michigan · 25100
Office
Unavailable
Facility
$334.29
No comparable office rate is available.
Minnesota
Minnesota · 25100
Office
Unavailable
Facility
$332.74
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 25100
Office
Unavailable
Facility
$334.92
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 25100
Office
Unavailable
Facility
$338.07
No comparable office rate is available.
Rest Of Missouri
Missouri · 25100
Office
Unavailable
Facility
$320.36
No comparable office rate is available.
Mississippi
Mississippi · 25100
Office
Unavailable
Facility
$313.57
No comparable office rate is available.
Montana**
Montana · 25100
Office
Unavailable
Facility
$346.98
No comparable office rate is available.
North Carolina
North Carolina · 25100
Office
Unavailable
Facility
$324.31
No comparable office rate is available.
North Dakota**
North Dakota · 25100
Office
Unavailable
Facility
$330.37
No comparable office rate is available.
Nebraska
Nebraska · 25100
Office
Unavailable
Facility
$315.10
No comparable office rate is available.
New Hampshire
New Hampshire · 25100
Office
Unavailable
Facility
$351.24
No comparable office rate is available.
Northern Nj
New Jersey · 25100
Office
Unavailable
Facility
$387.28
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 25100
Office
Unavailable
Facility
$372.29
No comparable office rate is available.
New Mexico
New Mexico · 25100
Office
Unavailable
Facility
$337.07
No comparable office rate is available.
Nevada**
Nevada · 25100
Office
Unavailable
Facility
$342.54
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 25100
Office
Unavailable
Facility
$415.00
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 25100
Office
Unavailable
Facility
$376.68
No comparable office rate is available.
Queens
New York · 25100
Office
Unavailable
Facility
$402.04
No comparable office rate is available.
Rest Of New York
New York · 25100
Office
Unavailable
Facility
$329.30
No comparable office rate is available.
Ohio
Ohio · 25100
Office
Unavailable
Facility
$330.90
No comparable office rate is available.
Oklahoma
Oklahoma · 25100
Office
Unavailable
Facility
$320.66
No comparable office rate is available.
Portland
Oregon · 25100
Office
Unavailable
Facility
$362.82
No comparable office rate is available.
Rest Of Oregon
Oregon · 25100
Office
Unavailable
Facility
$337.95
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 25100
Office
Unavailable
Facility
$362.52
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 25100
Office
Unavailable
Facility
$330.07
No comparable office rate is available.
Puerto Rico
Puerto Rico · 25100
Office
Unavailable
Facility
$348.68
No comparable office rate is available.
Rhode Island
Rhode Island · 25100
Office
Unavailable
Facility
$352.70
No comparable office rate is available.
South Carolina
South Carolina · 25100
Office
Unavailable
Facility
$328.54
No comparable office rate is available.
South Dakota**
South Dakota · 25100
Office
Unavailable
Facility
$328.41
No comparable office rate is available.
Tennessee
Tennessee · 25100
Office
Unavailable
Facility
$316.93
No comparable office rate is available.
Austin
Texas · 25100
Office
Unavailable
Facility
$355.01
No comparable office rate is available.
Beaumont
Texas · 25100
Office
Unavailable
Facility
$328.12
No comparable office rate is available.
Brazoria
Texas · 25100
Office
Unavailable
Facility
$340.22
No comparable office rate is available.
Dallas
Texas · 25100
Office
Unavailable
Facility
$343.48
No comparable office rate is available.
Fort Worth
Texas · 25100
Office
Unavailable
Facility
$341.96
No comparable office rate is available.
Galveston
Texas · 25100
Office
Unavailable
Facility
$341.94
No comparable office rate is available.
Houston
Texas · 25100
Office
Unavailable
Facility
$357.32
No comparable office rate is available.
Rest Of Texas
Texas · 25100
Office
Unavailable
Facility
$334.72
No comparable office rate is available.
Utah
Utah · 25100
Office
Unavailable
Facility
$332.89
No comparable office rate is available.
Virginia
Virginia · 25100
Office
Unavailable
Facility
$335.59
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 25100
Office
Unavailable
Facility
$348.68
No comparable office rate is available.
Vermont
Vermont · 25100
Office
Unavailable
Facility
$331.29
No comparable office rate is available.
Rest Of Washington
Washington · 25100
Office
Unavailable
Facility
$352.00
No comparable office rate is available.
Seattle (King Cnty)
Washington · 25100
Office
Unavailable
Facility
$391.13
No comparable office rate is available.
Wisconsin
Wisconsin · 25100
Office
Unavailable
Facility
$319.72
No comparable office rate is available.
West Virginia
West Virginia · 25100
Office
Unavailable
Facility
$334.49
No comparable office rate is available.
Wyoming**
Wyoming · 25100
Office
Unavailable
Facility
$339.74
No comparable office rate is available.
See how rates vary across the country
25100 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 25100 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$389.73
$354.30 × 110% = $389.73
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 25100 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
2,387
- Code
- 25100
- Physician work
- 3.92
- Practice expense
- 5.63
- Malpractice
- 0.84
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.92 | × 1.017 | 3.9866 |
| Practice expense | 5.63 | × 1.096 | 6.1705 |
| Malpractice | 0.84 | × 0.536 | 0.4502 |
| Total RVUs | 10.6074 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$354.30
Open 25100 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.92 | 1.017 |
| Practice expense | 5.63 | 1.096 |
| Malpractice | 0.84 | 0.536 |
(3.92 × 1.017 + 5.63 × 1.096 + 0.84 × 0.536) × $33.4009 = $354.30
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
25100 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $354.30 | RVU26D |
| 2026-07-01 | Not available in this setting | $354.30 | RVU26C |
| 2026-04-01 | Not available in this setting | $354.30 | RVU26B |
| 2026-01-01 | Not available in this setting | $354.30 | RVU26A |
| 2025-10-01 | Not available in this setting | $360.96 | RVU25D |
| 2025-07-01 | Not available in this setting | $360.96 | RVU25C |
| 2025-04-01 | Not available in this setting | $360.96 | RVU25B |
| 2025-01-01 | Not available in this setting | $360.96 | RVU25A |
25100 billing questions
When is this code more appropriate than 25101?
Use 25100 when the surgeon opens the wrist joint to obtain tissue for diagnostic evaluation. Code 25101 describes wrist-joint exploration or treatment rather than a biopsy-focused service.
Can the tissue examination be billed separately?
The operative service covers access to the joint and tissue collection. A laboratory or pathologist may report the examination of the submitted specimen as a separate service when performed.
How is a biopsy of both wrists reported?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support biopsy of both wrist joints.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,38425077,,Resect forearm/wrist tum<3cm,A,,12.61,8.90,NA,8.90,,3.36,24.87,24.87,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38525078,,Resect forarm/wrist tum 3cm>,A,,17.25,11.26,NA,11.26,,3.89,32.40,32.40,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38625085,,Incision of wrist capsule,A,,5.50,6.20,NA,6.20,,1.06,12.76,12.76,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38725100,,Biopsy of wrist joint,A,,3.92,5.63,NA,5.63,,0.84,10.39,10.39,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38825101,,Explore/treat wrist joint,A,,4.71,6.11,NA,6.11,,0.92,11.74,11.74,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38925105,,Remove wrist joint lining,A,,5.87,6.89,NA,6.89,,1.14,13.90,13.90,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39025107,,Remove wrist joint cartilage,A,,7.51,8.64,NA,8.64,,1.45,17.60,17.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536