Billing code 25135: Bone lesion surgeryMedicare rate & RVUs in Florida
Reports excision or curettage of a benign cyst or tumor in a carpal bone when the defect is filled with the patient's own bone graft.
CMS doesn’t publish an office rate for 25135 in Florida.
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 9 sections
What 25135 covers
An orthopedic or hand surgeon removes or curettes a benign bone cyst or tumor in a carpal bone, then fills the resulting defect with bone taken from the same patient. The operation is generally performed in an operating room. The code includes obtaining the autograft; it is distinguished from carpal bone lesion treatment without graft and from grafting with donor allograft.
The operative report should identify the affected carpal bone, the lesion and its benign character, the excision or curettage performed, and the use and source of the autograft. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral reporting is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 25135 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $584.17 |
| Miami | Unavailable | $626.89 |
| Rest Of Florida | Unavailable | $554.28 |
How the 25135 rate is calculated
Each of 25135’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 · 25135
RVUs × geographic indexes × conversion factor
Work6.90
6.90 RVUs× 1.000 GPCI
Practice expense7.83
7.83 RVUs× 1.000 GPCI
Malpractice1.47
1.47 RVUs× 1.000 GPCI
Adjusted RVUs
16.2000
Conversion factor
$33.4009
Medicare rate
$541.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25135
25135 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25135
Bone lesion surgery
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 25135
Bone lesion surgery
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
25135 without 50 · national facility
$541.09
Bone lesion surgery
25135-50 · Bilateral: 150%
$811.64
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).
25135 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25130Wrist bone lesion
- This code includes autografting after treatment of a carpal bone lesion; 25130 is the corresponding carpal bone procedure without graft.
- 25136Wrist bone lesion
- Choose 25135 for graft bone obtained from the patient. Choose 25136 when donor allograft is used.
- 25125Bone lesion excision
- Both include autograft for a benign bone lesion, but 25125 is for the radius or ulna rather than a carpal bone.
25135 billing questions
When should this code be selected instead of 25130?
Use 25135 when the carpal bone lesion is excised or curetted and the defect is filled with the patient's own bone. Code 25130 describes the corresponding carpal bone lesion procedure without graft.
How does 25135 differ from 25136?
Both involve a carpal bone lesion and grafting, but 25135 is for autograft and 25136 is for allograft. Document the graft source.
Can the bone-graft harvest be reported separately?
The autograft harvest is included in 25135. The code covers obtaining the patient's bone graft as part of the procedure.
What documentation supports reporting 25135?
Document the carpal bone involved, the benign cyst or tumor, the excision or curettage, and that the defect was grafted with bone obtained from the patient.
How is bilateral reporting handled?
For bilateral procedures reported with modifier 50, CMS pays 150%. The operative documentation should support treatment on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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
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