Billing code 25065: Soft-tissue biopsyMedicare rate & RVUs in Oregon
Report this code when a surgeon obtains a diagnostic tissue sample from a superficial soft-tissue lesion of the forearm or wrist.
Medicare pays $258.34–$281.18 for 25065 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 25065 covers
This service obtains a tissue sample from a superficial soft-tissue lesion in the forearm or wrist for diagnostic examination. An orthopedic, hand, or other surgeon typically performs an open biopsy in an office procedure room, ambulatory surgery center, or hospital. The goal is to sample tissue for diagnosis, rather than remove the lesion as definitive treatment. The operative note should identify the site and describe the lesion’s depth and the tissue sampled.
Choose this code for a superficial biopsy; use the deep-tissue sibling when the sampled tissue is deep. Document the clinical reason for sampling, the approach, and the specimen sent for examination. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery 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.
Where 25065 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $281.18 | $152.42 |
| Rest Of Oregon | $258.34 | $142.90 |
How the 25065 rate is calculated
Each of 25065’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 · 25065
RVUs × geographic indexes × conversion factor
Work1.99
1.99 RVUs× 1.000 GPCI
Practice expense5.57
5.57 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
7.8400
Conversion factor
$33.4009
Medicare rate
$261.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25065
25065 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25065
Soft-tissue biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 25065
Soft-tissue biopsy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
25065 without 50 · national office
$261.86
Soft-tissue biopsy
25065-50 · Bilateral: 150%
$392.79
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).
25065 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25066Soft-tissue biopsy
- Choose 25065 for a superficial sample and 25066 when the sampled forearm or wrist tissue is deep.
- 25075Forearm tumor excision
- 25075 describes excision of a superficial forearm lesion under 3 cm; 25065 describes biopsy for diagnostic sampling.
- 25076Forearm tumor excision
- 25076 describes excision of a deep forearm tumor under 3 cm. Use 25065 for superficial diagnostic sampling, not definitive tumor removal.
25065 billing questions
How does this code differ from 25066?
25065 is for a superficial soft-tissue biopsy of the forearm or wrist. Use 25066 when the sampled tissue is deep.
Should a biopsy code be used when the lesion is removed?
Use a biopsy code when tissue is sampled for diagnosis. When the lesion is excised, select the applicable excision code based on its depth and size.
Are the pathology examination and the biopsy bundled together?
This code represents obtaining the tissue sample. A separately performed pathology examination may be reported by the service that performs it.
How is a bilateral biopsy reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
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 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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