No office rate
Choose 25109 when the tendon itself is excised. Choose 25118 when the work is directed at the tendon sheath.
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CMS RVU26D · Effective 2026-10-01
25109 Tendon excision Medicare reimbursement rates in Ohio
Reports removal of a flexor or extensor tendon in the forearm or wrist, with each excised tendon counted separately. Compare 25109 office and facility rates across CMS payment localities in Ohio.
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 25109 in Ohio?
Ohio 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
$485.77
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Hand surgery
About 25109: Forearm or wrist tendon excision
Reports removal of a flexor or extensor tendon in the forearm or wrist, with each excised tendon counted separately.
This service removes a flexor or extensor tendon in the forearm or wrist. An orthopedic or hand surgeon may perform it when a tendon itself is diseased or damaged and must be excised. The operative report should identify the tendon, its location, and the extent of removal; a procedure directed at a tendon sheath or a wrist mass is a different service.
Report one unit for each tendon excised, supported by the operative details. The code has 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 other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays this procedure at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 25109
- 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 RVU6.77 · 45%
- Practice expense (office) RVU7.09 · 47%
- Malpractice RVU1.29 · 9%
313
Medicare services in 2024 · #3962 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.
25109 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
25111 describes primary wrist ganglion excision. A ganglion removal alone is not excision of a forearm or wrist tendon.
No office rate
25112 is for recurrent wrist ganglion excision; 25109 concerns excision of a flexor or extensor tendon.
No office rate
25115 describes radical removal of bursa or synovium involving a forearm or wrist tendon sheath, rather than excision of the tendon itself.
Compare 25109 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
Ohio →
Office / nonfacility
Unavailable
Facility
$485.77
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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 25109 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,391
- Code
- 25109
- Physician work
- 6.77
- Practice expense
- 7.09
- Malpractice
- 1.29
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.77 | × 1.000 | 6.7700 |
| Practice expense | 7.09 | × 0.913 | 6.4732 |
| Malpractice | 1.29 | × 1.008 | 1.3003 |
| Total RVUs | 14.5435 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$485.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.77 | 1 |
| Practice expense | 7.09 | 0.913 |
| Malpractice | 1.29 | 1.008 |
(6.77 × 1 + 7.09 × 0.913 + 1.29 × 1.008) × $33.4009 = $485.77
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.
25109 billing questions
How is this different from excision of a tendon sheath?
This code is for excision of the tendon itself. Use 25118 when the operative work removes tendon sheath tissue rather than the tendon.
How many units should be reported?
The descriptor is per tendon. Report each tendon excised, and make the operative note clear about the tendon and its forearm or wrist location.
Does excising a wrist ganglion support this code?
Not by itself. A ganglion excision is distinct from removing a flexor or extensor tendon; codes 25111 and 25112 describe primary and recurrent wrist ganglion excisions, respectively.
What is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For bilateral procedures reported with modifier 50, CMS pays this code at 150%.
Can an assistant or co-surgeon be reported?
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.
2,38825101,,Explore/treat wrist joint,A,,4.71,6.11,NA,6.11,,0.92,11.74,11.74,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38925105,,Remove wrist joint lining,A,,5.87,6.89,NA,6.89,,1.14,13.90,13.90,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39025107,,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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703