Surgical release of a single flexor or extensor tendon in the forearm or wrist to restore gliding function restricted by scar or adhesion.

Verified May 8, 2026 · 7 sources ↓

Medicare: $497.01
Work RVU: 6.55
Global, days: 90
Region: Wrist

Drawn from CMSAAPCMdclarityFindacodeEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Identify each tendon released by name (e.g., flexor digitorum profundus to index, extensor pollicis longus) — 'tendon released' alone will not survive audit.
Document the extent and character of adhesions or scar encountered intraoperatively, supporting medical necessity.
Record the surgical approach and confirmation of restored tendon excursion at the end of the case.
Specify laterality (left or right forearm/wrist) in both the operative note header and the body of the report.
If billing multiple units for multiple tendons, each tendon release must be individually described in the operative note.
For modifier 22, quantify increased complexity — dense post-traumatic scar, prior failed tenolysis, or neurovascular proximity — with objective language.

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 25295 covers operative tenolysis of a single flexor or extensor tendon in the forearm or wrist — the surgical freeing of a tendon bound down by scar tissue or adhesions that prevent normal excursion. Each tendon released is counted separately; if you free two tendons in the same session, bill the code twice with appropriate modifiers.

The 90-day global period applies. That window covers the operative session, the day-before visit, and all routine follow-up through day 90. Post-op therapy evaluations or injections for a separate condition still require modifier 24 or 25 to escape the global. Any unplanned return to the OR for a related complication (e.g., re-scarring requiring repeat release) uses modifier 78; an unrelated procedure in the same global window uses modifier 79.

This code sits in the Repair, Revision, and/or Reconstruction section of the forearm and wrist. It is most frequently billed by orthopedic surgery, plastic and reconstructive surgery, and hand surgery specialists. Laterality modifiers (LT/RT) are expected by most payers; missing them is a common clean-claim failure on upper extremity codes.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.55) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (14.88) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.55
Practice expense RVU	7.07
Malpractice RVU	1.26
Total RVU	14.88
Medicare national rate	$497.01
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	$497.01
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 25295 get rejected.

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

Missing laterality modifier (LT or RT) — many payers auto-deny upper extremity surgical codes without side designation.
Unit restriction denials when billing multiple units for multiple tendons; BCBS and some regional payers apply MUE limits and require appeal with operative note.
Global period conflict when post-op visits or therapy management are billed without modifier 24, triggering bundling edits.
Modifier 59 applied without adequate documentation of distinct procedural service when 25295 is billed alongside CTS release or other forearm procedures.
Medical necessity denial when the diagnosis code reflects acute injury rather than established scar/adhesion, mismatching the tenolysis indication.

Frequently asked questions

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

01Can I bill 25295 twice if I release two tendons in the same session?

Yes. The code is defined per tendon. Bill one unit per tendon released, list the higher-RVU procedure first, and append modifier 51 to the second unit. Each tendon must be individually named in the operative report.

02What's the difference between 25295 and 25300/25301?

25295 is tenolysis — freeing a tendon from scar without altering its attachment. Codes 25300 and 25301 are tenodesis procedures, where the tendon is anchored to bone to limit or stabilize motion. Different procedures, different indications, not interchangeable.

03Do I need modifier 59 when billing 25295 with carpal tunnel release (64721) on the same day?

Yes, if an NCCI edit bundles them. Modifier 59 (or XS for a distinct anatomic structure) documents that the tenolysis was performed on a separate tendon structure from the carpal tunnel release. Support it with an operative note that clearly distinguishes the two procedures.

04How does the 90-day global affect post-op hand therapy orders?

Therapy itself is not in the global — therapists bill their own codes. What is bundled: your routine post-op visits, dressing changes, and suture removal through day 90. If you evaluate a new problem or unrelated condition during a global visit, append modifier 24 to the E/M.

05When should I use modifier 78 vs. 79 for a return to the OR after 25295?

Modifier 78 is for an unplanned return related to the original tenolysis — for example, evacuation of a post-op hematoma or re-release of re-formed adhesions. Modifier 79 is for a procedure that is unrelated to the tenolysis performed during the same global window. Inverting them is an audit flag.

06Is modifier 50 appropriate for bilateral forearm tenolysis?

Yes, if the identical tendon is released on both sides in one session. Append modifier 50 and submit one line. Some payers prefer two lines with LT and RT. Verify your payer's bilateral billing preference before submitting — submission format differences are a common source of rejections, not denials.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the tendon name and location, adhesion characteristics, surgical approach, and confirmation of restored excursion directly from dictation — then flags if laterality is absent before the note is finalized. That prevents the two most common 25295 clean-claim failures: generic tendon identification that triggers audit and missing LT/RT that triggers auto-denial.

See how Mira captures CPT 25295 documentation