No office rate
Both codes describe radical resection of a forearm or wrist soft-tissue tumor. Select 25116 for a tumor under 5 cm and 25115 for the larger-size category.
On this page
CMS RVU26D · Effective 2026-10-01
25116 Tumor resection Medicare reimbursement rates in Alabama
Reports radical removal of a soft-tissue tumor in the forearm or wrist when the tumor measures less than 5 cm. Compare 25116 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 25116 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$515.98
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 25116: Small forearm or wrist soft-tissue tumor resection
Reports radical removal of a soft-tissue tumor in the forearm or wrist when the tumor measures less than 5 cm.
This code covers radical resection of a soft-tissue tumor in the forearm or wrist measuring less than 5 cm. The surgeon removes the tumor with the surrounding tissue needed for the planned resection, rather than simply removing a superficial lump or dissecting a tendon-sheath cyst. Orthopedic and hand surgeons commonly perform the procedure in an operating room when a soft-tissue tumor requires this extent of excision.
Choose the code based on the tumor’s size and the documented scope of resection; the operative report should identify the forearm or wrist site, tumor dimensions, and tissues removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity, and co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 25116
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.37 · 43%
- Practice expense (office) RVU8.32 · 49%
- Malpractice RVU1.41 · 8%
1.4K
Medicare services in 2024 · #2738 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.
25116 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
25110 is for a lesion involving a tendon sheath or joint capsule, such as a cyst. 25116 describes radical resection of a soft-tissue tumor.
No office rate
25111 is for primary wrist ganglion excision. It is not the code for radical resection of a soft-tissue tumor.
No office rate
25120 addresses a bone cyst or benign tumor of the radius or ulna. 25116 concerns soft tissue in the forearm or wrist.
Compare 25116 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$515.98
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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 25116 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,396
- Code
- 25116
- Physician work
- 7.37
- Practice expense
- 8.32
- Malpractice
- 1.41
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.37 | × 1.000 | 7.3700 |
| Practice expense | 8.32 | × 0.875 | 7.2800 |
| Malpractice | 1.41 | × 0.566 | 0.7981 |
| Total RVUs | 15.4481 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$515.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.37 | 1 |
| Practice expense | 8.32 | 0.875 |
| Malpractice | 1.41 | 0.566 |
(7.37 × 1 + 8.32 × 0.875 + 1.41 × 0.566) × $33.4009 = $515.98
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.
25116 billing questions
How does this differ from 25115?
These codes distinguish radical soft-tissue tumor resections by size. Use 25116 for a tumor under 5 cm; 25115 is the larger-size sibling.
Can this code be used for a wrist ganglion?
A routine wrist ganglion excision is not the same service as radical tumor resection. Use the ganglion code when that is the procedure performed and documented.
What documentation supports this code?
Document the forearm or wrist location, tumor dimensions, and the extent of tissue resected. The operative report should support radical resection rather than a limited or superficial excision.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
How are bilateral procedures and multiple procedures paid?
When reported bilaterally with modifier 50, CMS pays at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is 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 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.
2,39325111,,Remove wrist tendon lesion,A,,3.44,5.51,NA,5.51,,0.66,9.61,9.61,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39425112,,Reremove wrist tendon lesion,A,,4.55,5.86,NA,5.86,,0.88,11.29,11.29,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39525115,,Remove wrist/forearm lesion,A,,9.84,9.34,NA,9.34,,1.88,21.06,21.06,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39625116,,Remove wrist/forearm lesion,A,,7.37,8.32,NA,8.32,,1.41,17.10,17.10,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39725118,,Excise wrist tendon sheath,A,,4.40,5.83,NA,5.83,,0.84,11.07,11.07,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39825119,,Partial removal of ulna,A,,6.05,7.22,NA,7.22,,1.30,14.57,14.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39925120,,Removal of forearm lesion,A,,6.11,6.92,NA,6.92,,1.20,14.23,14.23,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515