No office rate
This code includes autografting after treatment of a carpal bone lesion; 25130 is the corresponding carpal bone procedure without graft.
On this page
CMS RVU26D · Effective 2026-10-01
25135 Bone lesion surgery Medicare reimbursement rates in Nebraska
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. Compare 25135 office and facility rates across CMS payment localities in Nebraska.
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 25135 in Nebraska?
Nebraska 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
$490.42
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 25135: Carpal bone lesion excision with autograft
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.
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.
CMS billing rules for 25135
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.90 · 43%
- Practice expense (office) RVU7.83 · 48%
- Malpractice RVU1.47 · 9%
27
Medicare services in 2024 · #5730 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.
25135 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Choose 25135 for graft bone obtained from the patient. Choose 25136 when donor allograft is used.
No office rate
Both include autograft for a benign bone lesion, but 25125 is for the radius or ulna rather than a carpal bone.
Compare 25135 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$490.42
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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 25135 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,403
- Code
- 25135
- Physician work
- 6.90
- Practice expense
- 7.83
- Malpractice
- 1.47
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.90 | × 1.000 | 6.9000 |
| Practice expense | 7.83 | × 0.923 | 7.2271 |
| Malpractice | 1.47 | × 0.378 | 0.5557 |
| Total RVUs | 14.6828 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$490.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.9 | 1 |
| Practice expense | 7.83 | 0.923 |
| Malpractice | 1.47 | 0.378 |
(6.9 × 1 + 7.83 × 0.923 + 1.47 × 0.378) × $33.4009 = $490.42
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.
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 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.
2,40025125,,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
2,40125126,,Remove/graft forearm lesion,A,,7.55,8.04,NA,8.04,,1.61,17.20,17.20,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40225130,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068