No office rate
Both describe deep forearm soft-tissue tumor excision; use 25073 when the tumor is 3 cm or greater, and 25076 when it is under 3 cm.
On this page
CMS RVU26D · Effective 2026-10-01
25076 Forearm tumor excision Medicare reimbursement rates in Rhode Island
Removal of a deep soft-tissue tumor in the forearm under 3 cm, reported when the operative service is excision rather than diagnostic biopsy. Compare 25076 office and facility rates across CMS payment localities in Rhode Island.
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 25076 in Rhode Island?
Rhode Island 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
$498.00
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Orthopedic surgery
About 25076: Deep forearm soft-tissue tumor excision under 3 cm
Removal of a deep soft-tissue tumor in the forearm under 3 cm, reported when the operative service is excision rather than diagnostic biopsy.
This code describes excision of a soft-tissue tumor in the forearm that lies beneath the subcutaneous tissue, such as beneath the fascia or within muscle, and measures less than 3 cm. Orthopedic or hand surgeons commonly perform the procedure in an operating room or outpatient surgical setting. It is distinct from removing a superficial forearm lesion and from taking a sample for diagnostic biopsy; the operative report should support that the tumor was deep and document its location and size.
Report the code for the excision itself, with documentation of the tumor’s dimensions, depth, and operative work. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. When performed bilaterally and reported with modifier 50, payment is 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 25076
- 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 RVU6.57 · 45%
- Practice expense (office) RVU6.83 · 46%
- Malpractice RVU1.30 · 9%
1.2K
Medicare services in 2024 · #2832 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.
25076 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$565.06
Both are for forearm lesions under 3 cm, but 25075 is for a superficial lesion and 25076 is for a deep soft-tissue tumor.
No office rate
Code 25066 is for diagnostic biopsy of deep forearm or wrist soft tissue. Code 25076 is for excision of a deep tumor under 3 cm.
Compare 25076 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$498.00
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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 25076 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,383
- Code
- 25076
- Physician work
- 6.57
- Practice expense
- 6.83
- Malpractice
- 1.30
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.57 | × 1.019 | 6.6948 |
| Practice expense | 6.83 | × 1.033 | 7.0554 |
| Malpractice | 1.30 | × 0.892 | 1.1596 |
| Total RVUs | 14.9098 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$498.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.57 | 1.019 |
| Practice expense | 6.83 | 1.033 |
| Malpractice | 1.3 | 0.892 |
(6.57 × 1.019 + 6.83 × 1.033 + 1.3 × 0.892) × $33.4009 = $498.00
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.
25076 billing questions
How does this differ from code 25075?
Code 25076 is for a deep tumor beneath the subcutaneous tissue; 25075 is for a superficial forearm lesion under 3 cm. The operative report should establish the tumor’s depth.
When should a biopsy code be used instead?
Use a biopsy code when the service obtains tissue for diagnosis rather than excising the tumor. Code 25066 describes a deep soft-tissue biopsy of the forearm or wrist.
What documentation supports code 25076?
Document the forearm location, tumor dimensions under 3 cm, deep relationship to the fascia or muscle, and the excision performed. Documentation should distinguish the tumor from a superficial lesion or a diagnostic sample.
Does the code have a global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery handled?
For bilateral procedures reported with modifier 50, Medicare payment is at 150%. The CMS multiple-procedure reduction also applies when multiple procedures are performed in the same session.
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.
2,38025071,,Exc forearm les sc 3 cm/>,A,,5.76,5.07,NA,5.07,,1.28,12.11,12.11,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38125073,,Exc forearm tum deep 3 cm/>,A,,6.95,6.79,NA,6.79,,1.47,15.21,15.21,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38225075,,Exc forearm les sc < 3 cm,A,,3.86,11.87,,4.51,,0.81,16.54,9.18,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38325076,,Exc forearm tum deep < 3 cm,A,,6.57,6.83,NA,6.83,,1.30,14.70,14.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38425077,,Resect forearm/wrist tum<3cm,A,,12.61,8.90,NA,8.90,,3.36,24.87,24.87,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38525078,,Resect forarm/wrist tum 3cm>,A,,17.25,11.26,NA,11.26,,3.89,32.40,32.40,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38625085,,Incision of wrist capsule,A,,5.50,6.20,NA,6.20,,1.06,12.76,12.76,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537