Billing code 25136: Wrist bone lesionMedicare rate & RVUs in Rhode Island
Reports removal or curettage of a benign wrist bone lesion followed by filling the resulting defect with allograft bone.
CMS doesn’t publish an office rate for 25136 in Rhode Island.
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 25136 covers
An orthopedic or hand surgeon uses this service to remove or curette a bone cyst or benign tumor in the wrist and fill the resulting defect with donor bone. The target is a bone lesion, such as one in the carpal region, rather than a tendon or other soft-tissue mass. The work is typically performed in an operating-room setting when the lesion requires operative treatment and grafting.
Select this code when the wrist bone lesion is treated with an allograft; the corresponding autograft service is a different code. The operative report should identify the lesion site, removal or curettage performed, and use of allograft. 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%. Modifier 50 for bilateral surgery is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
25136 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $490.43 |
How the 25136 rate is calculated
Each of 25136’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 · 25136
RVUs × geographic indexes × conversion factor
Work5.99
5.99 RVUs× 1.000 GPCI
Practice expense7.20
7.20 RVUs× 1.000 GPCI
Malpractice1.28
1.28 RVUs× 1.000 GPCI
Adjusted RVUs
14.4700
Conversion factor
$33.4009
Medicare rate
$483.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25136
25136 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25136
Wrist bone lesion
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 25136
Wrist bone lesion
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
25136 without 50 · national facility
$483.31
Wrist bone lesion
25136-50 · Bilateral: 150%
$724.97
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).
25136 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25135Bone lesion surgery
- The wrist bone lesion and grafting work are similar, but 25135 represents autogenous bone graft; 25136 represents allograft.
- 25130Wrist bone lesion
- This code represents wrist bone lesion removal or curettage without grafting. Choose 25136 when allograft is used to fill the defect.
- 25126Bone lesion surgery
- Both include allograft, but 25126 is for a forearm bone lesion; 25136 is for a wrist bone lesion.
25136 billing questions
How is this different from 25135?
Both cover removal or curettage of a wrist bone lesion with grafting. Use 25136 for allograft and 25135 for autogenous bone graft.
When would 25130 be more appropriate?
Use 25130 for removal or curettage of a wrist bone lesion without the grafting represented by this code.
Can the bone graft be reported separately?
The allograft is part of the service represented by 25136. The operative documentation should support that allograft was used to fill the lesion defect.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral surgery or other procedures in the same session?
Modifier 50 bilateral payment is 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is 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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