Summary & Overview
CPT 25112: Excision of Recurrent Wrist Ganglion
CPT code 25112 denotes surgical excision of a recurrent ganglion from the wrist, a common hand surgery aimed at relieving pain and mechanical symptoms. Nationally, this code captures repeat procedures for patients whose ganglia recur after prior conservative or surgical management, making it relevant for surgical utilization, quality reporting, and payer coverage determinations.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context explaining when excision of a recurrent wrist ganglion is performed and where it typically occurs (outpatient surgical settings or hospital outpatient departments). The publication summarizes benchmark measures for utilization and payment across major payers, highlights common billing considerations and code relationships, and outlines policy and coverage themes that affect prior authorization and medical necessity reviews.
This resource is intended for revenue cycle professionals, hand surgeons, and policy analysts who need a focused reference on coding and payer patterns for recurrent wrist ganglion excision. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 25112 describes the excision of a recurrent ganglion, a fluid-filled mass, from the wrist. This procedure is performed to relieve pain, limit nerve or tendon irritation, or address recurrent symptoms after prior treatment.
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Service type: Surgical excision of a recurrent ganglion from the wrist
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Typical site of service: Outpatient surgical setting, ambulatory surgery center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28–45-year-old adult presenting to an outpatient hand surgery or orthopedic clinic with a painful, palpable, fluid-filled wrist mass that intermittently limits wrist motion and causes localized tenderness. The patient reports weeks to months of symptoms, occasional numbness or aching, and attempts at conservative care such as splinting and aspiration or observation. On examination the surgeon documents a well-circumscribed, transilluminating cyst over the dorsal or volar wrist, positive fluctuation, and pain with wrist movement. Preoperative workflow includes history and physical, informed consent for excision of a recurrent ganglion, operative site marking, possible preoperative imaging (ultrasound or MRI) to delineate communication with the joint or tendon sheath, and pre-op anesthesia evaluation. The procedure is typically performed in an ambulatory surgery center or hospital outpatient department under local with sedation or regional block; general anesthesia may be used. Intraoperative steps include incision, dissection to the cyst stalk, excision of the ganglion and its stalk, hemostasis, and layered closure. Postoperative workflow includes short recovery, wound care instructions, activity restrictions, and follow-up for suture removal and assessment of recurrence and function. Billing uses 25112 for excision of a recurrent ganglion of the wrist when documented in the operative report.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |