Surgical removal of a subcutaneous soft-tissue tumor of the forearm or wrist measuring less than 3 cm, with specimen typically sent to pathology.

Verified May 8, 2026 · 7 sources ↓

Medicare: $552.45
Total RVUs: 16.54
Global, days: 90
Region: Wrist

Drawn from CMSEmednyAAPCCgsmedicareNIH

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Tumor size in centimeters — must confirm less than 3 cm to distinguish 25075 from 25071
Depth of dissection explicitly stated as subcutaneous to rule out subfascial codes 25076 and 25073
Anatomic location documented as forearm and/or wrist area
Operative note confirming specimen sent to pathology for analysis
Separate incision documentation if billing two lesions on the same date
Laterality (left vs. right forearm) noted in the operative report

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 25075 covers excision of a subcutaneous (above-fascia) soft-tissue tumor of the forearm or wrist when the tumor measures less than 3 cm. The code sits in a family that scales by depth and size: 25075 is subcutaneous/small, 25071 is subcutaneous/3 cm or greater, 25076 is subfascial/small, and 25073 is subfascial/3 cm or greater. Choosing the wrong code in this family is the most common audit flag — depth of dissection and tumor size must both be documented explicitly.

The 90-day global period applies. That means routine follow-up wound checks, suture removal, and any uncomplicated post-op visits within 90 days are bundled. If you need to bill a separate E/M during that window for an unrelated reason, attach modifier 24. For a related return to the OR (e.g., hematoma evacuation), use modifier 78. An unrelated procedure in the global period takes modifier 79.

Pathology is billed separately under the appropriate 88300-series code — it is not bundled into 25075. When two distinct forearm lesions are removed through separate incisions on the same day, report each separately with the appropriate code and laterality modifier (LT or RT), plus modifier 51 on the lower-value code.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.86
Practice expense RVU	11.87
Malpractice RVU	0.81
Total RVU	16.54
Medicare national rate	$552.45
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$552.45
HOPD (APC 5072) Hospital outpatient department	$1,687.37
ASC (PI G2) Ambulatory surgical center (freestanding)	$742.04

Common denial reasons

The recurring reasons claims for CPT 25075 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Depth not documented — payer downcodes or denies when operative note doesn't confirm subcutaneous dissection
Tumor size missing or ambiguous — triggers medical review or denial when size isn't recorded in the note
Wrong family code selected — 24071 (upper arm/elbow) billed instead of 25075 for a forearm lesion
Modifier 51 omitted when billing a second lesion same-day, causing NCCI bundling denial
Laterality modifier missing when bilateral or same-day bilateral forearm procedures are billed

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What separates 25075 from 25071?

Size. Both are subcutaneous forearm/wrist tumor excisions, but 25075 applies when the tumor is less than 3 cm and 25071 applies when it is 3 cm or greater. Document the measured size in centimeters in the operative note — not just 'small' or 'large.'

02What separates 25075 from 25076?

Depth. 25075 is subcutaneous (above the fascia); 25076 is subfascial (intramuscular or below the fascia), also less than 3 cm. The operative note must state the depth of dissection explicitly — audit teams flag notes that only say 'tumor excised' without specifying the tissue plane.

03Is pathology bundled into 25075?

No. Pathology is billed separately using the appropriate 88300-series code. Specimen submission is expected but does not affect the 25075 payment.

04Can I bill two lesions removed on the same day?

Yes, if they were removed through separate incisions. Bill the higher-value code first, append modifier 51 to the second code, and use LT/RT to document laterality. If both lesions came out through a single incision, bill only the code that matches the larger specimen.

05Does modifier 50 apply if both forearms are operated on the same day?

Modifier 50 applies for bilateral procedures on paired anatomic structures in the same session. For bilateral forearm excisions, you can use modifier 50 or bill two lines with LT and RT — confirm your payer's preference, as some commercial payers require separate line items with laterality modifiers rather than modifier 50.

06What global period applies, and what does it cover?

25075 carries a 90-day global period. Routine post-op visits, wound checks, and suture removal within 90 days are bundled. Use modifier 24 for an unrelated E/M in that window, modifier 78 for an unplanned related return to the OR, and modifier 79 for an unrelated procedure during the global period.

07Is 25075 site-of-service sensitive?

Yes. HOPD and ASC payments differ significantly — see the Site of Service comparison table on this page. When the procedure can be safely performed in an ASC or office, payer payment differentials can affect net reimbursement substantially.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures tumor location (forearm vs. wrist), measured size in centimeters, depth of dissection (subcutaneous vs. subfascial), and whether the specimen was sent to pathology — the four data points that lock in 25075 over its family codes. It also flags when two lesions are removed through separate incisions so the coder knows to split-bill rather than bundle, preventing the most common same-day excision denial.

See how Mira captures CPT 25075 documentation