Summary & Overview
CPT 25111: Excision of Wrist Ganglion (Dorsal or Volar)
CPT 25111 denotes the surgical excision of a wrist ganglion (dorsal or volar) and is used across outpatient surgical settings nationally. This procedure code captures definitive operative removal of ganglion cysts from the wrist, a common hand and wrist complaint that may present with pain, restricted motion, or cosmetic concern. Coverage and billing for CPT 25111 are relevant to a broad range of payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find in-depth context on clinical indications for excision, typical ambulatory surgical center utilization, and coding peers for related wrist and hand procedures. The publication outlines common documentation and billing considerations, how CPT 25111 relates to adjacent codes for repeat or more extensive wrist procedures, and typical place-of-service patterns. It also summarizes the scope of review by major payers and provides benchmarking and policy-oriented notes to inform coding accuracy and claim submission practices. Data not available in the input for specific payer policy differences or reimbursement benchmarks is identified where applicable.
CPT Code Overview
CPT 25111 describes the excision of a ganglion from the wrist, performed on either the dorsal or volar aspect. This is a surgical excision procedure typically carried out in an Ambulatory Surgical Center (POS 24). The code represents definitive operative management to remove a ganglion cyst from the wrist to relieve symptoms or address functional concerns.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an ambulatory surgical center with a painful, palpable mass over the dorsal wrist that limits wrist motion and causes intermittent aching. After clinical evaluation and imaging (eg, ultrasound or radiograph to rule out other pathology), the diagnosis of a wrist ganglion is documented (eg, M67.431 for right wrist or M67.432 for left wrist). The patient is scheduled for a surgical excision of the ganglion under regional or local anesthesia. The surgical workflow includes preoperative consent, marking of the operative site, sterile preparation, excision of the ganglion (dorsal or volar approach depending on location), hemostasis, layered wound closure, and brief postoperative recovery in the ambulatory surgical center prior to discharge with wound care instructions.
Coding Specifications
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Modifier
51– Multiple Procedures- Use when more than one surgical procedure is performed during the same operative session by the same surgeon and additional procedures are subject to multiple-procedure payment reductions.
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Modifier
59– Distinct Procedural Service- Use to indicate a procedure or service that is distinct or independent from other services performed on the same day; applicable when the excision is separate from another procedure performed in a different anatomic site or distinct session.