No office rate
Choose 25065 for a superficial sample and 25066 when the sampled forearm or wrist tissue is deep.
On this page
CMS RVU26D · Effective 2026-10-01
25065 Soft-tissue biopsy Medicare reimbursement rates in Wyoming
Report this code when a surgeon obtains a diagnostic tissue sample from a superficial soft-tissue lesion of the forearm or wrist. Compare 25065 office and facility rates across CMS payment localities in Wyoming.
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 25065 in Wyoming?
Wyoming 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
$259.43
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$143.53
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Musculoskeletal surgery
About 25065: Superficial forearm soft-tissue biopsy
Report this code when a surgeon obtains a diagnostic tissue sample from a superficial soft-tissue lesion of the forearm or wrist.
This service obtains a tissue sample from a superficial soft-tissue lesion in the forearm or wrist for diagnostic examination. An orthopedic, hand, or other surgeon typically performs an open biopsy in an office procedure room, ambulatory surgery center, or hospital. The goal is to sample tissue for diagnosis, rather than remove the lesion as definitive treatment. The operative note should identify the site and describe the lesion’s depth and the tissue sampled.
Choose this code for a superficial biopsy; use the deep-tissue sibling when the sampled tissue is deep. Document the clinical reason for sampling, the approach, and the specimen sent for examination. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 25065
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.99 · 25%
- Practice expense (office) RVU5.57 · 71%
- Malpractice RVU0.28 · 4%
398
Medicare services in 2024 · #3740 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.
25065 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$545.42
25075 describes excision of a superficial forearm lesion under 3 cm; 25065 describes biopsy for diagnostic sampling.
No office rate
25076 describes excision of a deep forearm tumor under 3 cm. Use 25065 for superficial diagnostic sampling, not definitive tumor removal.
Compare 25065 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
Wyoming** →
Office / nonfacility
$259.43
Facility
$143.53
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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 25065 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,378
- Code
- 25065
- Physician work
- 1.99
- Practice expense
- 5.57
- Malpractice
- 0.28
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.99 | × 1.000 | 1.9900 |
| Practice expense | 5.57 | × 1.000 | 5.5700 |
| Malpractice | 0.28 | × 0.740 | 0.2072 |
| Total RVUs | 7.7672 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$259.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.99 | 1 |
| Practice expense | 5.57 | 1 |
| Malpractice | 0.28 | 0.74 |
(1.99 × 1 + 5.57 × 1 + 0.28 × 0.74) × $33.4009 = $259.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.99 | 1 |
| Practice expense | 2.1 | 1 |
| Malpractice | 0.28 | 0.74 |
(1.99 × 1 + 2.1 × 1 + 0.28 × 0.74) × $33.4009 = $143.53
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.
25065 billing questions
How does this code differ from 25066?
25065 is for a superficial soft-tissue biopsy of the forearm or wrist. Use 25066 when the sampled tissue is deep.
Should a biopsy code be used when the lesion is removed?
Use a biopsy code when tissue is sampled for diagnosis. When the lesion is excised, select the applicable excision code based on its depth and size.
Are the pathology examination and the biopsy bundled together?
This code represents obtaining the tissue sample. A separately performed pathology examination may be reported by the service that performs it.
How is a bilateral biopsy reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
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.
2,37525031,,I&d forearm&/wrist bursa,A,,4.15,5.86,NA,5.86,,0.89,10.90,10.90,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37625035,,Inc dp bone crtx f/arm&/wrst,A,,7.46,7.82,NA,7.82,,1.59,16.87,16.87,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37725040,,Arthrt rdcrpl/midcarpl jt,A,,7.31,6.95,NA,6.95,,1.45,15.71,15.71,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37825065,,Biopsy forearm soft tissues,A,,1.99,5.57,,2.10,,0.28,7.84,4.37,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,37925066,,Biopsy forearm soft tissues,A,,4.16,5.75,NA,5.75,,0.82,10.73,10.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,38025071,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,