{"id":180996,"date":"2026-08-17T08:24:41","date_gmt":"2026-08-17T08:24:41","guid":{"rendered":"https:\/\/pabau.com\/?p=180996"},"modified":"2026-08-17T09:26:43","modified_gmt":"2026-08-17T09:26:43","slug":"cpt-code-25118","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/","title":{"rendered":"CPT code 25118: Synovectomy, extensor tendon sheath, wrist"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 25118: Synovectomy, extensor tendon sheath, wrist\",\"description\":\"Billing reference for CPT code 25118 (synovectomy, extensor tendon sheath, wrist, single compartment): indications, ICD-10 crosswalk, 2026 RVUs, modifiers, and global period.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-25118\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-07\",\"dateModified\":\"2026-08-17\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 25118 describes synovectomy of the extensor tendon sheath at the wrist, single compartment.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Rheumatoid arthritis and tenosynovitis are the most common indications, supported by ICD-10 codes M05.831, M06.031, and M65.031.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT 25119 adds resection of the distal ulna, while radical multi-compartment disease maps to CPT 25115 or 25116.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CMS puts 25118 at 11.07 total RVUs for 2026 with a 90-day global period, so post-op visits inside that window need a modifier.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&rsquo;s claims management software helps orthopedic and hand surgery practices track claim status, apply correct modifiers, and reduce denials.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 25118 covers synovectomy of the extensor tendon sheath at the wrist, single compartment. The surgeon strips inflamed synovial lining from one of the six dorsal wrist compartments. No bone is removed. That last point is what separates 25118 from CPT 25119.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most denials on this code come from three places. Modifier selection is the first. Operative notes that never state the single-compartment scope are the second. The third is a post-op visit billed inside the 90-day global period. Purpose-built <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine practice software<\/a> flags all three before the claim goes out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The American Medical Association&rsquo;s <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">CPT code set<\/a> places 25118 in the Musculoskeletal System section, under Excision Procedures on the Forearm and Wrist. The official descriptor reads: Synovectomy, extensor tendon sheath, wrist, single compartment. The aim is to relieve pain and restore wrist extension.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The single-compartment qualifier is what limits this code. Six extensor tendon compartments run across the dorsal wrist, each holding distinct tendons. CPT code 25118 covers only one of them. Radical tenosynovectomy across multiple sheaths is coded elsewhere, with CPT 25115 for flexor sheaths and CPT 25116 for extensor sheaths.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Details<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">25118<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Synovectomy, extensor tendon sheath, wrist, single compartment<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Musculoskeletal System &#8211; Excision Procedures on the Forearm and Wrist<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">90 days<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU (2026)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11.07<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Setting<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Facility (hospital outpatient or ASC). CMS lists no separate office rate.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Sibling code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">25119 (the same single-compartment synovectomy, with resection of the distal ulna)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-clinical-indications-and-when-to-use-cpt-25118\" class=\"wp-block-heading\">Clinical indications and when to use CPT 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Synovectomy of the extensor tendon sheath is performed when conservative management has failed to control synovial inflammation. That means corticosteroid injections, splinting, and physical therapy have not worked. The procedure is most common in patients whose inflammatory condition causes pain, swelling, or lost wrist extension.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Correct use of CPT code 25118 depends on confirming both the anatomical site and the scope. If the note does not establish extensor tendon sheath, wrist, and a single compartment, 25118 is the wrong code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hand therapists deliver much of the conservative care that comes first. Practices running that care on <a href=\"https:\/\/pabau.com\/industry\/occupational-therapy-software\/\">occupational therapy software<\/a> should log every modality that failed. That log is what establishes medical necessity when a payer reviews the surgery.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Rheumatoid arthritis (RA):<\/strong> The most common indication. Chronic synovial inflammation in RA patients can cause the extensor tendon sheath to thicken, restricting wrist movement.<\/li>\n\n\n\n<li><strong>Tenosynovitis:<\/strong> Inflammatory tenosynovitis that does not respond to non-operative care. The disease must be localized to one compartment to match the descriptor.<\/li>\n\n\n\n<li><strong>Seronegative inflammatory arthropathy:<\/strong> Conditions such as psoriatic arthritis or reactive arthritis producing localized extensor tenosynovitis.<\/li>\n\n\n\n<li><strong>Pigmented villonodular tenosynovitis (PVNS):<\/strong> A benign but locally aggressive condition of the synovial tissue requiring surgical excision.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Payer LCD policies vary on coverage. Confirm pre-authorization for rheumatoid indications before scheduling. Some commercial plans require documented failure of at least two conservative treatment modalities.<\/p>\n\n\n\n<h2 id=\"h-icd-10-codes-linked-to-cpt-code-25118\" class=\"wp-block-heading\">ICD-10 codes linked to CPT code 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity for CPT code 25118 must be supported by an appropriate ICD-10-CM diagnosis code. Laterality drives the choice. Codes ending in 1 indicate the right wrist, 2 the left wrist, and 3 both wrists. Use the most specific code available, or the claim will be denied on specificity grounds.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hand and wrist tendon diagnoses follow the same laterality pattern, as <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s66292d\/\">S66.292D<\/a> shows. The table below maps the diagnosis codes most often paired with this procedure.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Laterality<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M05.831<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rheumatoid arthritis with rheumatoid factor of right wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M05.832<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rheumatoid arthritis with rheumatoid factor of left wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M06.031<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rheumatoid arthritis without rheumatoid factor, right wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M06.032<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rheumatoid arthritis without rheumatoid factor, left wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M65.031<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Abscess of tendon sheath, right wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M65.032<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Abscess of tendon sheath, left wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M65.231<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Calcific tendinitis, right wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M67.331<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Transient synovitis, right wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Verify each code against current CMS ICD-10-CM guidelines before filing. Payer LCD and NCD policies vary, and a specific ICD-10 code does not guarantee coverage. Some commercial payers want 7th-character detail where the code family supports it, as <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s63631d\/\">S63.631D<\/a> does.<\/p>\n\n\n\n<h2 id=\"h-reimbursement-rates-and-medicare-fee-schedule-for-cpt-code-25118\" class=\"wp-block-heading\">Reimbursement rates and Medicare fee schedule for CPT code 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimbursement for CPT code 25118 runs on the Resource-Based Relative Value Scale, or RBRVS. Total payment reflects three RVU components multiplied by the annual conversion factor. That result is then adjusted for location through the Geographic Practice Cost Index, known as GPCI.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Office and facility rates usually differ, because practice expense RVUs run higher in an office setting. CPT 25118 works differently. CMS marks its non-facility practice expense as not applicable, so the file carries one total for both settings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a> lookup tool to pull locality-specific rates for the current year. The figures below come from the January 2026 national <a href=\"https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/physician\/pfs-relative-value-files\" target=\"_blank\" rel=\"nofollow noopener\">relative value file<\/a>. Values are refreshed annually, so check the current release before billing.<\/p>\n\n\n\n<h3 id=\"h-rvu-breakdown-for-cpt-25118\" class=\"wp-block-heading\">RVU breakdown for CPT 25118<\/h3>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">RVU component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">2026 national value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician time, skill, and intensity<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4.40<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Overhead attributable to the procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5.83<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Professional liability component<\/td>\n<td style=\"padding:12px 16px;color:#374151\">0.84<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work plus practice expense plus malpractice<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11.07<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Those are national values, before any geographic adjustment. Multiply 11.07 by the 2026 conversion factor of $33.4009 and the allowable is about $370. Clinicians in a qualifying alternative payment model use a slightly higher factor of $33.5675.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Commercial rates are negotiated separately. Most land at a percentage of the Medicare allowable, so the RVU total still drives the number.<\/p>\n\n\n\n<h2 id=\"h-applicable-modifiers-for-cpt-code-25118\" class=\"wp-block-heading\">Applicable modifiers for CPT code 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection directly affects claim adjudication for CPT code 25118. Missing or incorrect modifiers are among the top denial reasons for wrist surgery codes. Check the current <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/national-correct-coding-initiative-ncci-edits\" target=\"_blank\" rel=\"nofollow noopener\">NCCI edits<\/a> before billing, because CMS updates them quarterly.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on the right wrist<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on the left wrist<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same procedure on both wrists in one session. CMS applies a 150% payment adjustment to 25118. Some commercial plans still want separate lines with -LT and -RT.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When 25118 is billed with another procedure that NCCI would otherwise bundle, to show the services are distinct<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When the procedure took substantially more work than usual, such as extensive scarring or adhesions. Requires operative report detail and payer approval.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-80 \/ -82<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Surgical assistant<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare applies a statutory restriction here, so an assistant at surgery is not separately payable. Check commercial policies one by one.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-global-period-and-post-op-billing-rules-for-cpt-code-25118\" class=\"wp-block-heading\">Global period and post-op billing rules for CPT code 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 25118 carries a 90-day global surgery period, consistent with major surgical procedures in the musculoskeletal system. During this window, routine post-operative services are bundled into the surgical payment and cannot be billed separately.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Included in the global period:<\/strong> Pre-operative evaluation on the day of surgery, by the same physician, plus intraoperative and immediate post-operative care. Suture removal, routine wound checks, and related follow-up visits within 90 days are also bundled.<\/li>\n\n\n\n<li><strong>Not included (may be billed separately with modifier -24):<\/strong> Evaluation and management visits for a condition unrelated to the surgery. This also covers a new problem that appears during the global period. Document the unrelated diagnosis clearly in the visit note.<\/li>\n\n\n\n<li><strong>Modifier -79 for unrelated procedures:<\/strong> Append modifier -79 when a different surgical procedure is needed during the global period. It tells the payer the new procedure is unrelated.<\/li>\n\n\n\n<li><strong>Modifier -78 for return to the OR:<\/strong> Use modifier -78 when the patient returns to the operating room during the global period. It applies to complications of the original procedure.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Billing a standard office visit during the 90-day global period without a modifier is one of the most common denials for this code. The same window governs other upper-limb procedures, including <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23650\/\">CPT 23650<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Train front desk and billing staff to flag every post-operative appointment for 25118 patients. The modifier decision happens before submission, not after the denial arrives.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Flag all CPT 25118 post-op appointments in your scheduling system. When a follow-up is booked within 90 days of a synovectomy, billing staff should check whether the visit relates to the surgery. That answer decides the E\/M code and the modifier. Skipping this step is the single fastest way to generate a recoverable denial.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-cpt-25118-vs-cpt-25119-key-differences\" class=\"wp-block-heading\">CPT 25118 vs. CPT 25119: Key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The most frequent coding question around CPT code 25118 is how it differs from CPT 25119. Both describe the same single-compartment synovectomy of the extensor tendon sheath at the wrist. The difference is bone work.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 25119 adds resection of the distal ulna, known as a Darrach-type resection. Nothing in 25119 signals a wider synovectomy. Coders who read it as the extensive version of 25118 pick the wrong code.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Element<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 25118<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 25119<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Synovectomy, extensor tendon sheath, wrist, single compartment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Compartments treated<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One, exactly as in 25118<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Bone work<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None, soft tissue only<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Includes resection of the distal ulna (Darrach-type resection)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Typical indication<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Localized tenosynovitis or early RA involving one compartment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rheumatoid wrist with a painful, prominent distal ulna (caput ulnae syndrome)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU (2026)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4.40<\/td>\n<td style=\"padding:12px 16px;color:#374151\">6.05<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU (2026)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11.07<\/td>\n<td style=\"padding:12px 16px;color:#374151\">14.57<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Reporting together<\/td>\n<td style=\"padding:12px 16px;color:#374151\" colspan=\"2\">Report only one of the two per wrist per session. CPT 25119 already includes the synovectomy described by 25118. Verify current CMS NCCI tables before billing both codes for any single session.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Disease across several sheaths<\/td>\n<td style=\"padding:12px 16px;color:#374151\" colspan=\"2\">Neither code applies. Use CPT 25115 for flexor tendon sheaths, or CPT 25116 for extensor sheaths, with or without transposition of the dorsal retinaculum.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The operative report decides the code. If the surgeon cleaned out one extensor compartment and left the ulna alone, CPT code 25118 is correct. If the same operation included resection of the distal ulna, report CPT 25119 on its own. If the note describes radical tenosynovectomy across several sheaths, move to CPT 25115 or CPT 25116.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">At the 2026 conversion factor, the two codes sit about $117 apart per case. That is what an ambiguous operative note costs when the coder has to guess. Picking the closer-looking code without documentation support is also a compliance risk.<\/p>\n\n\n\n<h2 id=\"h-related-cpt-codes-in-the-forearm-and-wrist-section\" class=\"wp-block-heading\">Related CPT codes in the forearm and wrist section<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Orthopedic and hand surgery billing teams meet CPT code 25118 alongside companion codes in the same anatomical grouping. Knowing the family prevents under-coding, over-coding, and bundling errors. The total RVU column below uses the January 2026 national file. Differences in surgical scope therefore show up as differences in payment.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Total RVU (2026)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25000<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incision, extensor tendon sheath, wrist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incision only, not excision or synovectomy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10.19<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25111<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision of ganglion, wrist (dorsal or volar); primary<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Ganglion cyst excision, not synovectomy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">9.61<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25112<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision of ganglion, wrist (dorsal or volar); recurrent<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Recurrent ganglion, higher complexity than 25111<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11.29<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25115<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radical excision of bursa, synovia of wrist, or forearm tendon sheaths; flexors<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radical excision on the flexor side of the wrist and forearm<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21.06<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25116<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radical excision of bursa, synovia of wrist, or forearm tendon sheaths; extensors, with or without transposition of dorsal retinaculum<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Extensor-side counterpart to 25115, and the code for radical multi-sheath disease<\/td>\n<td style=\"padding:12px 16px;color:#374151\">17.10<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25118<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Synovectomy, extensor tendon sheath, wrist, single compartment<\/td>\n<td style=\"padding:12px 16px;color:#374151\"><strong>This code.<\/strong> Inflammatory, one compartment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11.07<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">25119<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The same single-compartment synovectomy as 25118, plus a distal ulna resection<\/td>\n<td style=\"padding:12px 16px;color:#374151\">14.57<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Prophylactic treatment of the same bones sits further out in the family, at <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-25492\/\">CPT 25492<\/a>. It carries 25.25 total RVUs, more than twice this code. A desk-level <a href=\"https:\/\/pabau.com\/templates\/medical-coding-cheat-sheet\/\">coding cheat sheet<\/a> helps when a note could plausibly land in more than one range.<\/p>\n\n\n\n<h2 id=\"h-billing-and-documentation-requirements-for-cpt-code-25118\" class=\"wp-block-heading\">Billing and documentation requirements for CPT code 25118<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Documentation problems are the primary reason CPT code 25118 claims are denied on audit rather than at submission. The operative report has to support the code before the claim is filed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices running <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> can build pre-submission checklists that flag missing operative report elements. <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA compliance<\/a> also requires that operative documentation stays secure and retrievable for a payer audit.<\/p>\n\n\n\n<h3 id=\"h-operative-report-requirements\" class=\"wp-block-heading\">Operative report requirements<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Anatomical site:<\/strong> Explicitly name extensor tendon sheath and wrist. Generic wrist surgery language is not enough.<\/li>\n\n\n\n<li><strong>Compartment count:<\/strong> State the specific compartment number, such as first extensor compartment. Alternatively, describe that only a single compartment was addressed. This is the documented basis for choosing 25118 over 25115 and 25116.<\/li>\n\n\n\n<li><strong>Distal ulna:<\/strong> State whether the distal ulna was resected. That one detail separates CPT 25118 from CPT 25119, so an ambiguous note invites a downcode or an audit finding.<\/li>\n\n\n\n<li><strong>Extent of synovial excision:<\/strong> Describe the tissue removed, not just the incision made. Note the degree of synovial hypertrophy found and the amount of tissue excised.<\/li>\n\n\n\n<li><strong>Laterality:<\/strong> Right or left wrist, stated clearly in the operative header and in the body of the report.<\/li>\n\n\n\n<li><strong>Clinical indication:<\/strong> Cite the diagnosis, such as rheumatoid tenosynovitis or PVNS. Note failure of conservative treatment where it applies.<\/li>\n<\/ul>\n\n\n\n<h3 id=\"h-pre-authorization-and-common-denial-reasons\" class=\"wp-block-heading\">Pre-authorization and common denial reasons<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Many commercial payers require pre-authorization for CPT code 25118. Submit the request with the operative plan, the supporting ICD-10 code, and evidence of prior conservative treatment. A standard <a href=\"https:\/\/pabau.com\/templates\/medical-prior-authorization-form\/\">prior authorization form<\/a> keeps those three elements in one place.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare does not require pre-authorization for this code. Documentation still has to support medical necessity on any retrospective audit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Four denials account for most of the recoverable revenue on this code.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A missing laterality modifier, either -RT or -LT.<\/li>\n\n\n\n<li>Operative documentation that never states the single-compartment scope.<\/li>\n\n\n\n<li>Reporting 25118 with 25119 for the same wrist, when 25119 already covers that synovectomy.<\/li>\n\n\n\n<li>An E\/M visit billed inside the 90-day global period without modifier -24.<\/li>\n<\/ul>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Add one line to your wrist synovectomy operative template that records whether the distal ulna was resected. Coders can then separate CPT 25118 from CPT 25119 without querying the surgeon. Add a second line for the number of tendon sheaths treated, which is what sends a case to CPT 25115 or 25116.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">How claims management software keeps CPT 25118 claims clean<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In most hand surgery practices, the facts that decide this code sit in different places. The compartment count and the distal ulna decision live in the operative note. The claim is built somewhere else, often days later, by someone who was not in the room.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau keeps the operative note and the claim on one patient record. A coder can confirm single-compartment scope and check whether the ulna was resected. That is enough to separate 25118 from 25119 without a query back to the surgeon.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-day global period gets the same treatment. Post-op appointments stay visible against the surgery date. An E\/M code can be held back, or given modifier -24, before the claim reaches the payer. Every Pabau subscription includes the <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">medical records management<\/a>, claims, and scheduling tools involved.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-25118\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau submits insurer claims automatically, so a CPT 25118 claim only leaves the practice once its coding has been checked.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce billing denials across your surgical code set                <\/h3>\n\n                <p class=\"description\">\n                    Pabau helps orthopedic and hand surgery practices manage claims, apply correct modifiers, and track post-operative billing windows. See how our claims management tools handle complex surgical code workflows.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 25118 is a narrowly scoped surgical code where documentation precision decides whether the claim survives. Three details carry most of the risk. Confirm single-compartment scope, append the correct laterality modifier, and check whether the distal ulna was resected.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After that, the 90-day global period separates a high first-pass acceptance rate from a queue of recoverable denials. That is a <a href=\"https:\/\/pabau.com\/blog\/what-is-healthcare-revenue-cycle-management\/\">revenue cycle management<\/a> problem as much as a coding one. Every post-op encounter for three months has to be checked against the surgery date.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices handling a high volume of surgical wrist codes need those checks inside the system that already holds the operative note. Pabau supports orthopedic and hand surgery billing teams with pre-submission claim checks, modifier tracking, and post-operative billing windows.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The right <a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">practice management platform<\/a> is the difference between predictable collections and a backlog of fixable denials. To see how Pabau fits a hand surgery billing workflow, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing another upper-limb reconstruction?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-24410\/\">CPT 24410<\/a> walks through the humeral osteotomy code, its 90-day global period, and its documentation requirements.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a shoulder reduction without anesthesia?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23650\/\">CPT 23650<\/a> shows how CPT separates closed treatment from open repair.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Reporting a subsequent encounter for a humerus fracture?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s42302k\/\">S42.302K<\/a> explains the 7th-character rules that drive specificity denials.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Managing a 90-day global period on a spine case?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-22600\/\">CPT 22600<\/a> applies the same post-operative billing window to posterior cervical arthrodesis.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing an upper-limb orthotic after surgery?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-l1010\/\">L1010<\/a> covers the axilla sling and the documentation a payer expects with it.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786952182959\"><h3 class=\"schema-faq-question\">What does CPT code 25118 cover?<\/h3> <p class=\"schema-faq-answer\">CPT code 25118 covers synovectomy of the extensor tendon sheath at the wrist, limited to a single compartment. The surgeon removes the inflamed synovial membrane from one of the six dorsal wrist compartments. The goal is to relieve pain and restore function. Patients typically have rheumatoid arthritis or localized tenosynovitis.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182960\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 25118?<\/h3> <p class=\"schema-faq-answer\">Laterality modifiers -RT for right and -LT for left are required by most payers on every claim. Modifier -50 covers bilateral procedures in the same session, though some commercial plans prefer separate line items with -RT and -LT. Modifier -59 distinguishes 25118 from other same-day procedures caught by NCCI bundling edits.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182961\"><h3 class=\"schema-faq-question\">What is the global period for CPT 25118?<\/h3> <p class=\"schema-faq-answer\">CPT 25118 carries a 90-day global surgery period. Routine post-operative visits, wound checks, and related follow-up care are bundled into the surgical payment. None of them can be billed separately during this window. Unrelated E\/M visits during the global period require modifier -24 with clear documentation of the unrelated diagnosis.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182962\"><h3 class=\"schema-faq-question\">Is CPT 25118 covered by Medicare?<\/h3> <p class=\"schema-faq-answer\">Medicare covers CPT code 25118 when medical necessity is established with an appropriate ICD-10-CM diagnosis code. Common choices are M05.831 for rheumatoid arthritis of the right wrist, or M65.031 for an abscess of the tendon sheath. Medicare does not require pre-authorization. The record must still show the clinical indication and, where relevant, that conservative treatment failed.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182963\"><h3 class=\"schema-faq-question\">What is the difference between CPT 25118 and 25119?<\/h3> <p class=\"schema-faq-answer\">CPT 25118 and CPT 25119 describe the same single-compartment synovectomy of the extensor tendon sheath at the wrist. CPT 25119 adds resection of the distal ulna, a Darrach-type resection. The extent of synovial disease is not the deciding factor. Radical, multi-sheath tenosynovectomy is coded with CPT 25115 for flexors or CPT 25116 for extensors.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182964\"><h3 class=\"schema-faq-question\">Can CPT 25118 and 25119 be billed together?<\/h3> <p class=\"schema-faq-answer\">No. CPT 25119 already includes the single-compartment synovectomy described by 25118, so only one of the two is reported per wrist per session. If the surgeon resected the distal ulna, report 25119 on its own. Check current CMS NCCI tables before attempting any unbundling with modifier -59.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952182965\"><h3 class=\"schema-faq-question\">What ICD-10 codes are linked to CPT 25118?<\/h3> <p class=\"schema-faq-answer\">Three pairs cover most claims. M05.831 and M05.832 report rheumatoid arthritis with rheumatoid factor of the right and left wrist. M06.031 and M06.032 report rheumatoid arthritis without rheumatoid factor. M65.031 and M65.032 report an abscess of the tendon sheath. Match the laterality, then verify the code against current CMS ICD-10-CM guidelines.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CPT code 25118 covers synovectomy of the extensor tendon sheath at the wrist, single compartment. The surgeon strips inflamed synovial lining from one of the six dorsal wrist compartments. No bone is removed. That last point is what separates 25118 from CPT 25119. Most denials on this code come from three places. Modifier selection is [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":180995,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"83","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[2387,1162,1602,1236,2668,1666],"class_list":["post-180996","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-claim-denials","tag-cpt-codes","tag-cpt-modifiers","tag-medicare-reimbursement","tag-musculoskeletal-coding","tag-orthopedic-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 25118: RVUs, modifiers, and global period (2026)<\/title>\n<meta name=\"description\" content=\"CPT 25118 covers single-compartment extensor tendon sheath synovectomy at the wrist. CMS lists 11.07 total RVUs and a 90-day global period.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 25118: RVUs, modifiers, and global period (2026)\" \/>\n<meta property=\"og:description\" content=\"CPT 25118 covers single-compartment extensor tendon sheath synovectomy at the wrist. 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Patients typically have rheumatoid arthritis or localized tenosynovitis.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182960\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182960\",\"name\":\"What modifiers apply to CPT code 25118?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Laterality modifiers -RT for right and -LT for left are required by most payers on every claim. Modifier -50 covers bilateral procedures in the same session, though some commercial plans prefer separate line items with -RT and -LT. Modifier -59 distinguishes 25118 from other same-day procedures caught by NCCI bundling edits.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182961\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182961\",\"name\":\"What is the global period for CPT 25118?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 25118 carries a 90-day global surgery period. Routine post-operative visits, wound checks, and related follow-up care are bundled into the surgical payment. None of them can be billed separately during this window. Unrelated E\\\/M visits during the global period require modifier -24 with clear documentation of the unrelated diagnosis.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182962\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182962\",\"name\":\"Is CPT 25118 covered by Medicare?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare covers CPT code 25118 when medical necessity is established with an appropriate ICD-10-CM diagnosis code. Common choices are M05.831 for rheumatoid arthritis of the right wrist, or M65.031 for an abscess of the tendon sheath. Medicare does not require pre-authorization. The record must still show the clinical indication and, where relevant, that conservative treatment failed.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182963\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182963\",\"name\":\"What is the difference between CPT 25118 and 25119?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 25118 and CPT 25119 describe the same single-compartment synovectomy of the extensor tendon sheath at the wrist. CPT 25119 adds resection of the distal ulna, a Darrach-type resection. The extent of synovial disease is not the deciding factor. Radical, multi-sheath tenosynovectomy is coded with CPT 25115 for flexors or CPT 25116 for extensors.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182964\",\"position\":6,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182964\",\"name\":\"Can CPT 25118 and 25119 be billed together?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. CPT 25119 already includes the single-compartment synovectomy described by 25118, so only one of the two is reported per wrist per session. If the surgeon resected the distal ulna, report 25119 on its own. Check current CMS NCCI tables before attempting any unbundling with modifier -59.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182965\",\"position\":7,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-25118\\\/#faq-question-1786952182965\",\"name\":\"What ICD-10 codes are linked to CPT 25118?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Three pairs cover most claims. M05.831 and M05.832 report rheumatoid arthritis with rheumatoid factor of the right and left wrist. M06.031 and M06.032 report rheumatoid arthritis without rheumatoid factor. M65.031 and M65.032 report an abscess of the tendon sheath. 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Off the clock: binging true crime docuseries, baking and dreaming about travel.","url":"https:\/\/pabau.com\/fr\/blog\/author\/maja-popovska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182959","position":1,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182959","name":"What does CPT code 25118 cover?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 25118 covers synovectomy of the extensor tendon sheath at the wrist, limited to a single compartment. The surgeon removes the inflamed synovial membrane from one of the six dorsal wrist compartments. The goal is to relieve pain and restore function. Patients typically have rheumatoid arthritis or localized tenosynovitis.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182960","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182960","name":"What modifiers apply to CPT code 25118?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Laterality modifiers -RT for right and -LT for left are required by most payers on every claim. Modifier -50 covers bilateral procedures in the same session, though some commercial plans prefer separate line items with -RT and -LT. Modifier -59 distinguishes 25118 from other same-day procedures caught by NCCI bundling edits.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182961","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182961","name":"What is the global period for CPT 25118?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 25118 carries a 90-day global surgery period. Routine post-operative visits, wound checks, and related follow-up care are bundled into the surgical payment. None of them can be billed separately during this window. Unrelated E\/M visits during the global period require modifier -24 with clear documentation of the unrelated diagnosis.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182962","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182962","name":"Is CPT 25118 covered by Medicare?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Medicare covers CPT code 25118 when medical necessity is established with an appropriate ICD-10-CM diagnosis code. Common choices are M05.831 for rheumatoid arthritis of the right wrist, or M65.031 for an abscess of the tendon sheath. Medicare does not require pre-authorization. The record must still show the clinical indication and, where relevant, that conservative treatment failed.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182963","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182963","name":"What is the difference between CPT 25118 and 25119?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 25118 and CPT 25119 describe the same single-compartment synovectomy of the extensor tendon sheath at the wrist. CPT 25119 adds resection of the distal ulna, a Darrach-type resection. The extent of synovial disease is not the deciding factor. Radical, multi-sheath tenosynovectomy is coded with CPT 25115 for flexors or CPT 25116 for extensors.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182964","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182964","name":"Can CPT 25118 and 25119 be billed together?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. CPT 25119 already includes the single-compartment synovectomy described by 25118, so only one of the two is reported per wrist per session. If the surgeon resected the distal ulna, report 25119 on its own. Check current CMS NCCI tables before attempting any unbundling with modifier -59.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182965","position":7,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-25118\/#faq-question-1786952182965","name":"What ICD-10 codes are linked to CPT 25118?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Three pairs cover most claims. M05.831 and M05.832 report rheumatoid arthritis with rheumatoid factor of the right and left wrist. M06.031 and M06.032 report rheumatoid arthritis without rheumatoid factor. M65.031 and M65.032 report an abscess of the tendon sheath. Match the laterality, then verify the code against current CMS ICD-10-CM guidelines.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"cpt code 25118","seo_title":"CPT code 25118: RVUs, modifiers, and global period (2026)","meta_description":"CPT 25118 covers single-compartment extensor tendon sheath synovectomy at the wrist. CMS lists 11.07 total RVUs and a 90-day global period.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"cpt code 25118 reimbursement","score":61},{"keyword":"cpt code 25118 modifiers","score":67},{"keyword":"cpt code 25118 global period","score":56}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/180996","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/comments?post=180996"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/180996\/revisions"}],"predecessor-version":[{"id":181221,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/180996\/revisions\/181221"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media\/180995"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media?parent=180996"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/categories?post=180996"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/tags?post=180996"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}