Use 25100 for open wrist-joint biopsy when tissue is sampled for diagnosis. Use 25105 when the operation removes synovial tissue therapeutically.
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CMS RVU26D · Effective 2026-10-01
25105 Wrist synovectomy Medicare reimbursement rates in Maine
Reports open removal of inflamed or abnormal synovial tissue from the wrist joint, typically to treat persistent synovitis rather than obtain a biopsy. Compare 25105 office and facility rates across CMS payment localities in Maine.
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 25105 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$431.47–$448.15
2 of 2 localities have a supported rate.
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 25105: Open wrist joint synovectomy
Reports open removal of inflamed or abnormal synovial tissue from the wrist joint, typically to treat persistent synovitis rather than obtain a biopsy.
The surgeon opens the wrist joint and removes synovial tissue, often to treat persistent proliferative synovitis associated with inflammatory arthritis or another ongoing joint condition. An orthopedic or hand surgeon typically performs the operation in a hospital or ambulatory surgery setting. This code describes treatment of the joint lining; it is distinct from sampling a small amount of tissue for diagnosis and from removing articular cartilage or a tendon sheath.
Report the service when the operative record supports open wrist-joint exposure and synovectomy. Documentation should identify the treated wrist, the indication, and the synovial tissue removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 25105
- 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 RVU5.87 · 42%
- Practice expense (office) RVU6.89 · 50%
- Malpractice RVU1.14 · 8%
439
Medicare services in 2024 · #3660 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.
25105 compared with similar codes
Office rates for Maine, from the same CMS release.
25107 addresses removal of wrist-joint cartilage; 25105 addresses removal of synovial lining.
29845 describes complete wrist synovectomy performed arthroscopically. This code describes open synovectomy.
25118 concerns excision of a wrist or forearm tendon sheath. This code treats synovium within the wrist joint.
Compare 25105 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$431.47
Southern Maine →
Office / nonfacility
Unavailable
Facility
$448.15
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25105 billing questions
How is this different from a wrist-joint biopsy?
This code is for therapeutic removal of synovial tissue through open joint exposure. A wrist-joint biopsy is for obtaining tissue samples for diagnostic examination.
Does this code describe arthroscopic synovectomy?
No. This code describes an open procedure. Arthroscopic wrist synovectomy codes distinguish limited from complete synovectomy.
What documentation supports reporting the procedure?
The operative note should support open wrist-joint exposure and removal of synovial tissue, and identify the treated wrist and clinical indication.
What does the 90-day global period include?
The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance paid?
CMS lists this as a bilateral procedure; reporting modifier 50 is paid at 150%.
When may an assistant or co-surgeon be paid?
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.
