No office rate
This is a closely related wrist tendon procedure. Distinguish the codes by matching the full descriptor to the operative technique documented.
On this page
CMS RVU26D · Effective 2026-10-01
25301 Tendon fusion Medicare reimbursement rates in Pennsylvania
Reports an operation joining tendons at the wrist to alter or stabilize tendon function, rather than transferring a tendon or repairing the wrist joint. Compare 25301 office and facility rates across CMS payment localities in Pennsylvania.
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 25301 in Pennsylvania?
Pennsylvania 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
$574.50–$625.62
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 25301: Wrist tendon fusion
Reports an operation joining tendons at the wrist to alter or stabilize tendon function, rather than transferring a tendon or repairing the wrist joint.
The surgeon joins tendons at the wrist as a reconstructive procedure to change or stabilize their action. It may be performed by an orthopedic hand surgeon or plastic surgeon in an operating room, commonly for a wrist tendon imbalance or deformity when the operative plan calls for tendon fusion rather than a tendon transfer. The operative report should identify the tendons joined and the wrist treated.
Report the code when the documented operation is fusion of tendons at the wrist; distinguish it from tendon transplantation and procedures on the wrist joint. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral surgery reported with modifier 50, payment is 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted under the listed CMS rules.
CMS billing rules for 25301
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.38 · 47%
- Practice expense (office) RVU7.93 · 44%
- Malpractice RVU1.63 · 9%
481
Medicare services in 2024 · #3601 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.
25301 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Use 25310 for forearm tendon transplantation. Use 25301 when the documented operation joins tendons at the wrist.
No office rate
Code 25315 concerns revision of hand tendons for palsy. This code is for fusion of tendons at the wrist.
No office rate
Code 25320 concerns repair or revision of the wrist joint; this code describes a tendon procedure, not joint repair.
Compare 25301 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$625.62
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$574.50
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25301 billing questions
How is tendon fusion different from a tendon transplant?
This code describes joining tendons at the wrist. Codes 25310 and 25312 describe forearm tendon transplantation; select based on the operation actually documented.
What should the operative report document?
Document the wrist treated, the tendons joined, and the operative technique and purpose. These details distinguish tendon fusion from tendon transfer or wrist-joint repair.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS payment is 150% under the listed rule.
Can an assistant surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted under the listed CMS rules.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are paid at 50% under the standard multiple-procedure reduction.
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.
2,42625290,,Incise wrist/forearm tendon,A,,5.29,6.11,NA,6.11,,1.01,12.41,12.41,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42725295,,Release wrist/forearm tendon,A,,6.55,7.07,NA,7.07,,1.26,14.88,14.88,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42825300,,Fusion of tendons at wrist,A,,8.79,8.99,NA,8.99,,1.87,19.65,19.65,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,42925301,,Fusion of tendons at wrist,A,,8.38,7.93,NA,7.93,,1.63,17.94,17.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43025310,,Transplant forearm tendon,A,,8.78,9.56,NA,9.56,,1.67,20.01,20.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43125312,,Transplant forearm tendon,A,,9.57,8.43,NA,8.43,,1.88,19.88,19.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,43225315,,Revise palsy hand tendon(s),A,,10.41,8.96,NA,8.96,,2.21,21.58,21.58,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00