Billing code 25111: Wrist ganglion excisionMedicare rate & RVUs in Ohio
Excision of a primary dorsal or volar wrist ganglion, reported when the surgeon removes the cyst and its attachment rather than treating a recurrence.
CMS doesn’t publish an office rate for 25111 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 25111 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $305.15 |
How the 25111 rate is calculated
Each of 25111’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 25111
RVUs × geographic indexes × conversion factor
Work3.44
3.44 RVUs× 1.000 GPCI
Practice expense5.51
5.51 RVUs× 1.000 GPCI
Malpractice0.66
0.66 RVUs× 1.000 GPCI
Adjusted RVUs
9.6100
Conversion factor
$33.4009
Medicare rate
$320.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25111
25111 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25111
Wrist ganglion excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25111
Wrist ganglion excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25111 without 50 · national facility
$320.98
Wrist ganglion excision
25111-50 · Bilateral: 150%
$481.47
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
25111 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25112Tendon lesion excision
- Choose 25112 for a recurrent wrist ganglion after prior excision; 25111 is for primary excision.
- 25110Lesion excision
- 25110 addresses an eligible tendon-sheath or joint-capsule lesion of the forearm or wrist. 25111 identifies primary excision of a wrist ganglion.
- 25118Tendon sheath excision
- 25118 concerns excision of wrist tendon sheath, whereas 25111 is for removal of a primary wrist ganglion.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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