No office rate
Choose 25000 for incision of an extensor tendon sheath. This code is for release of the wrist joint capsule.
On this page
CMS RVU26D · Effective 2026-10-01
25085 Wrist capsulotomy Medicare reimbursement rates in Washington
A surgeon incises the wrist joint capsule to release contracture and improve restricted motion when stiffness arises from capsular tightness. Compare 25085 office and facility rates across CMS payment localities in Washington.
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 25085 in Washington?
Washington 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
$431.10–$475.91
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.
Orthopedic surgery
About 25085: Wrist capsular contracture release
A surgeon incises the wrist joint capsule to release contracture and improve restricted motion when stiffness arises from capsular tightness.
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.
CMS billing rules for 25085
- 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 RVU5.50 · 43%
- Practice expense (office) RVU6.20 · 49%
- Malpractice RVU1.06 · 8%
236
Medicare services in 2024 · #4178 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.
25085 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
Choose 25001 for the specified flexor tendon procedure. Use this code when the operative target is a contracted wrist joint capsule.
No office rate
This code describes capsular release for restricted wrist motion; 25040 describes a wrist arthrotomy service rather than contracture release.
Compare 25085 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$431.10
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$475.91
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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 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.
2,38325076,,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
2,38725100,,Biopsy of wrist joint,A,,3.92,5.63,NA,5.63,,0.84,10.39,10.39,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38825101,,Explore/treat wrist joint,A,,4.71,6.11,NA,6.11,,0.92,11.74,11.74,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38925105,,Remove wrist joint lining,A,,5.87,6.89,NA,6.89,,1.14,13.90,13.90,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00