No office rate
Choose 25118 when the operative target is wrist tendon sheath tissue. Choose 25105 when the surgeon removes the lining of the wrist joint.
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CMS RVU26D · Effective 2026-10-01
25118 Tendon sheath excision Medicare reimbursement rates in Michigan
Reports surgical removal of diseased wrist tendon sheath tissue, commonly for persistent tenosynovitis when the operative target is the sheath rather than the tendon or joint. Compare 25118 office and facility rates across CMS payment localities in Michigan.
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 25118 in Michigan?
Michigan 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
$356.43–$382.18
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.
Hand surgery
About 25118: Wrist tendon sheath excision
Reports surgical removal of diseased wrist tendon sheath tissue, commonly for persistent tenosynovitis when the operative target is the sheath rather than the tendon or joint.
A hand or orthopedic surgeon removes abnormal synovial tissue from around wrist tendons, as in a tenosynovectomy for persistent inflammatory or proliferative tenosynovitis. A typical clinical setting is surgery for wrist tendon-sheath disease, including disease associated with rheumatoid arthritis. The operative target is the tendon sheath and its diseased lining, not the tendon itself or the wrist joint lining.
Report the code when the documented procedure excises wrist tendon sheath tissue; a discrete cyst or other focal lesion may instead point to a lesion-excision code. The operative report should identify the wrist, the involved sheath or tendon compartment, the condition treated, and the tissue removed. Medicare 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 services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25118
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.40 · 40%
- Practice expense (office) RVU5.83 · 53%
- Malpractice RVU0.84 · 8%
3.3K
Medicare services in 2024 · #2105 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.
25118 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
25118 addresses the sheath surrounding wrist tendons; 25109 is for excision of tendon tissue in the forearm or wrist.
No office rate
25118 describes excision of diseased wrist tendon sheath tissue, commonly a tenosynovectomy. 25110 is directed to a discrete lesion of the tendon sheath or capsule.
Compare 25118 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
Detroit →
Office / nonfacility
Unavailable
Facility
$382.18
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$356.43
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25118 billing questions
When is this code appropriate instead of a tendon lesion excision code?
Use this code for removal of diseased wrist tendon sheath tissue, such as a tenosynovectomy. A discrete cyst or other localized lesion of the sheath may fit a lesion-excision code instead.
How is this different from wrist joint synovectomy?
This procedure removes tissue around wrist tendons. Wrist joint synovectomy addresses the lining inside the joint.
What should the operative note document?
Document the wrist and involved tendon sheath or compartment, the underlying condition, and the sheath tissue excised. The note should make clear that the work involved the sheath rather than the tendon or joint lining.
Does Medicare include related postoperative visits in the payment?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral procedures and other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported for this operation?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
2,39425112,,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
2,40025125,,Remove/graft forearm lesion,A,,7.48,8.02,NA,8.02,,1.59,17.09,17.09,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00