CPT code 25085: Wrist capsulotomy2026 Medicare rate & RVUs in Texas
A surgeon incises the wrist joint capsule to release contracture and improve restricted motion when stiffness arises from capsular tightness.
CMS doesn’t publish an office rate for 25085 in Texas.
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 25085 covers
This procedure releases a contracted wrist joint capsule that limits motion. An orthopedic or hand surgeon typically performs the operation in a facility operating room, often for persistent wrist stiffness after trauma, surgery, or immobilization. The target is the capsule itself; a tendon-sheath release or removal of a wrist mass describes a different service.
Report the code when the operative documentation supports incision or release of the wrist capsule for contracture, including the treated side and the functional restriction addressed. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 25085 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $434.54 |
| Beaumont | Unavailable | $405.04 |
| Brazoria | Unavailable | $418.01 |
| Dallas | Unavailable | $421.99 |
| Fort Worth | Unavailable | $420.38 |
| Galveston | Unavailable | $420.13 |
| Houston | Unavailable | $439.53 |
| Rest Of Texas | Unavailable | $412.20 |
How the 25085 rate is calculated
Each of 25085’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 · 25085
RVUs × geographic indexes × conversion factor
Work5.50
5.50 RVUs× 1.000 GPCI
Practice expense6.20
6.20 RVUs× 1.000 GPCI
Malpractice1.06
1.06 RVUs× 1.000 GPCI
Adjusted RVUs
12.7600
Conversion factor
$33.4009
Medicare rate
$426.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 25085
25085 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25085
Wrist capsulotomy
| 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) | 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 · 25085
Wrist capsulotomy
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
25085 without 50 · national facility
$426.20
Wrist capsulotomy
25085-50 · Bilateral: 150%
$639.30
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).
25085 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 25000Tendon release
- Choose 25000 for incision of an extensor tendon sheath. This code is for release of the wrist joint capsule.
- 25001Tendon sheath incision
- Choose 25001 for the specified flexor tendon procedure. Use this code when the operative target is a contracted wrist joint capsule.
- 25040Wrist arthrotomy
- This code describes capsular release for restricted wrist motion; 25040 describes a wrist arthrotomy service rather than contracture release.
25085 billing questions
When is this code appropriate instead of a wrist arthrotomy code?
Use this code when the operative goal is release of a contracted wrist capsule. A wrist arthrotomy code describes a different joint procedure, such as access for diagnostic evaluation or biopsy.
Can a tendon-sheath incision be reported as a wrist capsulotomy?
No. Codes 25000 and 25001 address tendon-sheath procedures, while this code requires work on the wrist joint capsule.
What documentation supports reporting this procedure?
Document the capsular contracture or tightness, the resulting motion restriction, the wrist and side treated, and the operative release performed.
How should bilateral procedures be reported?
For bilateral wrist procedures, modifier 50 is paid at 150% under the CMS facts for this code.
How does the multiple-procedure rule affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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