No office rate
Choose 25112 for a recurrent wrist ganglion after prior excision; 25111 is for primary excision.
On this page
CMS RVU26D · Effective 2026-10-01
25111 Wrist ganglion excision Medicare reimbursement rates in New Jersey
Excision of a primary dorsal or volar wrist ganglion, reported when the surgeon removes the cyst and its attachment rather than treating a recurrence. Compare 25111 office and facility rates across CMS payment localities in New Jersey.
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 25111 in New Jersey?
New Jersey 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
$344.65–$359.17
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 25111: Primary wrist ganglion excision
Excision of a primary dorsal or volar wrist ganglion, reported when the surgeon removes the cyst and its attachment rather than treating a recurrence.
This procedure removes a ganglion arising at the wrist, commonly from the joint capsule or a tendon sheath. The surgeon exposes the cyst, removes it and addresses its attachment as part of the operation. Orthopedic and hand surgeons typically perform the procedure in an operating room or ambulatory surgery setting. A dorsal or volar wrist ganglion is the characteristic clinical target; this code identifies a primary excision rather than removal of a recurrent ganglion.
Report 25111 when the operative record supports a wrist ganglion and documents that it is not recurrent. Include the wrist side, location, diagnosis, and operative findings. CMS 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 other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 25111
- 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 RVU3.44 · 36%
- Practice expense (office) RVU5.51 · 57%
- Malpractice RVU0.66 · 7%
7.6K
Medicare services in 2024 · #1617 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.
25111 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
25110 addresses an eligible tendon-sheath or joint-capsule lesion of the forearm or wrist. 25111 identifies primary excision of a wrist ganglion.
No office rate
25118 concerns excision of wrist tendon sheath, whereas 25111 is for removal of a primary wrist ganglion.
Compare 25111 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$359.17
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$344.65
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25111 billing questions
When should 25111 be chosen over 25112?
Use 25111 for primary excision of a wrist ganglion. Use 25112 when the ganglion is recurrent after prior excision.
How does 25111 differ from 25110?
25111 is specific to primary ganglion excision at the wrist. Consider 25110 for an eligible tendon-sheath or joint-capsule lesion of the forearm or wrist that is not being reported as a primary wrist ganglion.
What documentation supports reporting 25111?
Document the wrist side and ganglion location, the diagnosis, whether it is primary or recurrent, and the operative findings and removal.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. CMS also includes the day-before preoperative visit in the global period.
How are bilateral procedures and other procedures in the same session handled?
CMS pays bilateral reporting with modifier 50 at 150%. When multiple procedures are performed in the same 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?
CMS does not pay assistant-at-surgery services 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.
2,39025107,,Remove wrist joint cartilage,A,,7.51,8.64,NA,8.64,,1.45,17.60,17.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39125109,,Excise tendon forearm/wrist,A,,6.77,7.09,NA,7.09,,1.29,15.15,15.15,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39225110,,Remove wrist tendon lesion,A,,3.94,5.39,NA,5.39,,0.78,10.11,10.11,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39325111,,Remove wrist tendon lesion,A,,3.44,5.51,NA,5.51,,0.66,9.61,9.61,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39425112,,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