No office rate
Use 25120 for forearm bone-lesion excision or curettage without internal fixation. This code describes the procedure when fixation is part of the operative work.
On this page
CMS RVU26D · Effective 2026-10-01
25145 Bone lesion removal Medicare reimbursement rates in Hawaii
Removal or curettage of a radius or ulna bone lesion with internal fixation, reported when the operative work includes stabilizing the treated bone. Compare 25145 office and facility rates across CMS payment localities in Hawaii.
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 25145 in Hawaii?
Hawaii 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
$517.00
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 25145: Forearm bone lesion removal with fixation
Removal or curettage of a radius or ulna bone lesion with internal fixation, reported when the operative work includes stabilizing the treated bone.
The surgeon removes or curettes a lesion in the radius or ulna and stabilizes the treated bone with internal fixation. This is an operative service typically performed by an orthopedic or hand surgeon in a hospital operating room or ambulatory surgery center. The fixation is part of the distinction from lesion removal without fixation; a procedure limited to soft tissue or a wrist joint is not this service.
The operative report should identify the affected forearm bone, the lesion and its treatment, and the fixation performed. Distinguish this service from bone-lesion procedures that include grafting or more extensive tumor resection based on the work documented. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25145
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.38 · 42%
- Practice expense (office) RVU7.32 · 49%
- Malpractice RVU1.34 · 9%
38
Medicare services in 2024 · #5522 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.
25145 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code is associated with autogenous grafting after forearm lesion removal. Select based on whether grafting or fixation is documented as the defining additional work.
No office rate
This code is associated with allograft reconstruction after forearm lesion removal. It differs from fixation without that grafting work.
No office rate
25170 describes resection of a radius or ulna tumor. It is distinct from lesion removal with fixation when the documented operation is a more extensive tumor resection.
Compare 25145 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$517.00
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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 25145 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,405
- Code
- 25145
- Physician work
- 6.38
- Practice expense
- 7.32
- Malpractice
- 1.34
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.38 | × 1.000 | 6.3800 |
| Practice expense | 7.32 | × 1.137 | 8.3228 |
| Malpractice | 1.34 | × 0.579 | 0.7759 |
| Total RVUs | 15.4787 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$517.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.38 | 1 |
| Practice expense | 7.32 | 1.137 |
| Malpractice | 1.34 | 0.579 |
(6.38 × 1 + 7.32 × 1.137 + 1.34 × 0.579) × $33.4009 = $517.00
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.
25145 billing questions
How does this differ from 25120?
This code is for forearm bone-lesion removal with internal fixation. Code 25120 describes lesion excision or curettage without that fixation work.
Can bone grafting be reported with this service?
Choose the applicable grafting code when the lesion procedure includes grafting, rather than assuming grafting is included here. The operative report should make the reconstruction performed clear.
What documentation supports reporting this code?
Document whether the lesion involved the radius or ulna, the removal or curettage performed, and the internal fixation used to stabilize the bone.
How is the code handled when both forearms are treated?
CMS lists this as a bilateral procedure. When performed bilaterally, modifier 50 is paid at 150%.
Is postoperative care separately reported during the global period?
Related postoperative care for 90 days is included in the global period, along with the day-before preoperative visit.
May an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery 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 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.
2,40225130,,Removal of wrist lesion,A,,5.29,6.60,NA,6.60,,1.01,12.90,12.90,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40325135,,Remove & graft wrist lesion,A,,6.90,7.83,NA,7.83,,1.47,16.20,16.20,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40425136,,Remove & graft wrist lesion,A,,5.99,7.20,NA,7.20,,1.28,14.47,14.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40525145,,Remove forearm bone lesion,A,,6.38,7.32,NA,7.32,,1.34,15.04,15.04,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40625150,,Partial removal of ulna,A,,7.20,7.37,NA,7.37,,1.44,16.01,16.01,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40725151,,Partial removal of radius,A,,7.49,7.40,NA,7.40,,1.45,16.34,16.34,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40825170,,Resect radius/ulnar tumor,A,,21.65,13.55,NA,13.55,,4.61,39.81,39.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014