No office rate
Both address qualifying bone lesions of the radius or ulna, but 25120 is for treatment without graft; 25126 includes allograft.
On this page
CMS RVU26D · Effective 2026-10-01
25126 Bone lesion surgery Medicare reimbursement rates in Wyoming
Reports curettage or excision of a benign bone lesion in the radius or ulna when the resulting defect is filled with allograft. Compare 25126 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 25126 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
No supported rate
Facility setting
$560.51
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.
Orthopedic surgery
About 25126: Forearm bone lesion excision with allograft
Reports curettage or excision of a benign bone lesion in the radius or ulna when the resulting defect is filled with allograft.
This procedure treats a bone cyst or benign tumor in the radius or ulna by removing or curetting the lesion and filling the resulting bone defect with donor bone graft. An orthopedic or hand surgeon typically performs it in an operating room. The operative report should identify the affected bone, describe the lesion removal, and document that allograft was used to fill the defect.
Select this code for the radius or ulna when allograft is used; the no-graft and autograft versions are separate codes. The 90-day global period 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 other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 25126
- 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 RVU7.55 · 44%
- Practice expense (office) RVU8.04 · 47%
- Malpractice RVU1.61 · 9%
33
Medicare services in 2024 · #5591 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.
25126 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Both include grafting after radius-or-ulna lesion treatment. Choose 25125 for autograft and 25126 for allograft.
No office rate
This code concerns a carpal bone and autograft, while 25126 concerns the radius or ulna and allograft.
Compare 25126 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
Unavailable
Facility
$560.51
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 25126 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,401
- Code
- 25126
- Physician work
- 7.55
- Practice expense
- 8.04
- Malpractice
- 1.61
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.55 | × 1.000 | 7.5500 |
| Practice expense | 8.04 | × 1.000 | 8.0400 |
| Malpractice | 1.61 | × 0.740 | 1.1914 |
| Total RVUs | 16.7814 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$560.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.55 | 1 |
| Practice expense | 8.04 | 1 |
| Malpractice | 1.61 | 0.74 |
(7.55 × 1 + 8.04 × 1 + 1.61 × 0.74) × $33.4009 = $560.51
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.
25126 billing questions
How does this differ from 25125?
Use 25126 when the defect is filled with allograft. Code 25125 describes the corresponding procedure using autograft.
When is 25120 more appropriate?
Use 25120 for qualifying lesion removal or curettage in the radius or ulna when no graft is used. Code 25126 includes allograft use.
What documentation supports 25126?
Document the radius or ulna involved, the bone cyst or benign tumor treatment, and use of allograft to fill the 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 are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS pays bilateral reporting with modifier 50 at 150%.
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.
2,39825119,,Partial removal of ulna,A,,6.05,7.22,NA,7.22,,1.30,14.57,14.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,39925120,,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
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.,,,,,,