Summary & Overview
CPT 25105: Wrist Synovectomy, Surgical Excision of Synovium
CPT code 25105 denotes a surgical wrist synovectomy in which the surgeon makes an incision to expose the wrist joint and removes inflamed synovial tissue, commonly indicated for rheumatoid arthritis and other inflammatory conditions. This code is important nationally because it captures a targeted operative intervention that can affect surgical utilization, post-operative care planning, and specialty-surgeon billing patterns.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for wrist synovectomy, expected sites of service, and common procedural considerations. The publication outlines typical payer coverage considerations, common modifiers associated with surgical services where available, and guidance on documentation elements tied to surgical indications and intraoperative findings.
The report supplies benchmarks and comparative context for utilization and reimbursement where available, highlights policy updates that may affect authorization and coverage for operative management of inflammatory wrist disease, and summarizes coding nuances for accurate claim submission. Data not available in the input is noted where applicable; the focus remains on clinical description, service setting, and the national relevance of CPT code 25105 for surgical and billing stakeholders.
Billing Code Overview
CPT code 25105 describes a surgical procedure to expose the wrist joint and excise inflamed synovial tissue around the carpal bones. This operation is typically performed for patients with rheumatoid arthritis or other inflammatory arthropathies to reduce pain and improve joint function.
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Service type: Surgical procedure, synovectomy of the wrist
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Typical site of service: Hospital operating room or ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old person with long-standing rheumatoid arthritis who presents with progressive dorsal wrist pain, swelling, reduced range of motion, and tenosynovitis refractory to medical therapy (disease-modifying antirheumatic drugs and corticosteroid injections). After clinical examination and wrist imaging (X-ray and MRI) confirming synovial proliferation and inflammatory erosive changes surrounding the radiocarpal and midcarpal joints, the hand surgeon schedules a wrist synovectomy under regional or general anesthesia. The clinical workflow includes preoperative evaluation (medical clearance, medication management for immunosuppression), perioperative nerve block or general anesthesia, a dorsal wrist incision to expose the joint, excision of inflamed synovium from around the carpal bones and radiocarpal joint, hemostasis, and layered wound closure. Postoperative care includes pain control, short immobilization in a splint, early hand therapy for range of motion and strengthening, and monitoring for infection or wound complications. The procedure is typically performed in an ambulatory surgery center or hospital operating room, with most patients discharged the same day if stable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | When no specific modifier applies; typically not reported to payors that require a blank modifier field |