No office rate
Select 25130 for a lesion in a carpal bone; 25120 addresses a bone lesion in the radius or ulna.
On this page
CMS RVU26D · Effective 2026-10-01
25130 Wrist bone lesion Medicare reimbursement rates in Vermont
Reports operative removal or curettage of a cyst or benign tumor in a carpal bone when the procedure does not include bone grafting. Compare 25130 office and facility rates across CMS payment localities in Vermont.
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 25130 in Vermont?
Vermont 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
$412.00
1 of 1 localities have a supported rate.
Payment area: Vermont
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 25130: Carpal bone lesion excision or curettage
Reports operative removal or curettage of a cyst or benign tumor in a carpal bone when the procedure does not include bone grafting.
An orthopedic surgeon uses this service to remove or curette a cyst or benign tumor arising in a carpal bone. It describes treatment of the bone lesion itself, rather than removal of a wrist tendon-sheath mass or a lesion in the radius or ulna. The procedure is generally performed in an operating room, with the excised material available for pathologic examination when indicated.
Choose the code when the operative report identifies the carpal bone treated and documents excision or curettage without grafting. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 25130
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.29 · 41%
- Practice expense (office) RVU6.60 · 51%
- Malpractice RVU1.01 · 8%
306
Medicare services in 2024 · #3980 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.
25130 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This code is for carpal bone lesion removal or curettage without grafting. Compare 25135 when bone grafting is part of the wrist procedure.
No office rate
Use 25130 when the procedure does not include grafting. Consider 25136 when grafting is performed and the code's grafting criteria are met.
No office rate
25110 concerns a wrist tendon lesion, not a lesion arising within a carpal bone.
Compare 25130 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
Vermont →
Office / nonfacility
Unavailable
Facility
$412.00
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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 25130 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,402
- Code
- 25130
- Physician work
- 5.29
- Practice expense
- 6.60
- Malpractice
- 1.01
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.29 | × 1.000 | 5.2900 |
| Practice expense | 6.60 | × 0.990 | 6.5340 |
| Malpractice | 1.01 | × 0.506 | 0.5111 |
| Total RVUs | 12.3351 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$412.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.29 | 1 |
| Practice expense | 6.6 | 0.99 |
| Malpractice | 1.01 | 0.506 |
(5.29 × 1 + 6.6 × 0.99 + 1.01 × 0.506) × $33.4009 = $412.00
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.
25130 billing questions
How is this different from removing a wrist tendon lesion?
This code is for a lesion within a carpal bone. Codes 25110 and 25111 concern tendon-related lesions, so the operative note should establish which structure contains the lesion.
When should a grafted wrist bone-lesion code be considered?
Use 25130 for removal or curettage without bone grafting. When grafting is part of the procedure, compare the applicable grafted wrist-lesion code, 25135 or 25136.
What should the operative report document?
Document the carpal bone involved, the lesion treated, and whether the surgeon excised or curetted it. Record graft use when applicable, since it may change the code selection.
How does CMS handle bilateral reporting and multiple procedures?
With modifier 50, CMS pays this bilateral procedure at 150%. For multiple procedures in one session, CMS pays the highest-valued procedure in full and applies the standard reduction to the others.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or another surgeon be paid for this operation?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.
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.
2,39925120,,Removal of forearm lesion,A,,6.11,6.92,NA,6.92,,1.20,14.23,14.23,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40025125,,Remove/graft forearm lesion,A,,7.48,8.02,NA,8.02,,1.59,17.09,17.09,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40125126,,Remove/graft forearm lesion,A,,7.55,8.04,NA,8.04,,1.61,17.20,17.20,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40225130,,Removal of wrist lesion,A,,5.29,6.60,NA,6.60,,1.01,12.90,12.90,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40325135,,Remove & graft wrist lesion,A,,6.90,7.83,NA,7.83,,1.47,16.20,16.20,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40425136,,Remove & graft wrist lesion,A,,5.99,7.20,NA,7.20,,1.28,14.47,14.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,40525145,,Remove forearm bone lesion,A,,6.38,7.32,NA,7.32,,1.34,15.04,15.04,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817