CPT 25115 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 25115: Extensive Soft Tissue Debridement Involving Bursa/Synovium/Tendon

CPT code 25115 represents an extensive surgical procedure for removal of diseased soft tissue involving the bursa, synovium, and/or tendon. Nationally, this code captures higher-complexity musculoskeletal soft-tissue debridements performed in operative settings and is relevant for hospitals, ambulatory surgery centers, and orthopedic and hand surgery practices. Use of this code signals more extensive anatomic involvement than limited or superficial debridement codes and can affect clinical documentation, utilization tracking, and payment adjudication.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the procedure represented by 25115, plus context on typical sites of service and common billing modifiers associated with operative musculoskeletal procedures. The publication provides benchmarks for utilization and expected documentation elements, highlights policy considerations that commonly affect coverage and claims processing, and outlines the clinical scenarios that typically drive use of this code.

This summary is intended for coding professionals, practice managers, and policy analysts seeking clear, national-level context on the clinical meaning and billing implications of CPT code 25115.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare25115CPTsoft tissue debridementbursasynoviumtendonoperative procedureorthopedicssurgical coding

Billing Code Overview

CPT code 25115 describes an extensive surgical removal of diseased soft tissues where the procedure involves bursa, synovium, and/or tendon anatomy. The description indicates debridement or excision of inflamed or damaged tissue beyond a limited scope, consistent with procedures addressing significant pathological involvement of peri-tendinous and peri-bursal structures.

Service Type: Extensive soft tissue debridement involving bursa, synovium, and/or tendon anatomy

Typical Site of Service: Operative setting (ambulatory surgical center or hospital outpatient/inpatient operating room), focused on musculoskeletal soft-tissue structures

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient presents with chronic pain, crepitus, and reduced range of motion in the wrist after progressive degenerative changes and recurrent tenosynovitis refractory to conservative care (splinting, NSAIDs, corticosteroid injections). Imaging demonstrates extensive synovial proliferation, inflamed bursal tissue, and degenerative tendon sheath involvement. The orthopedic hand surgeon schedules an open debridement and extensive synovectomy with removal of diseased bursa and involved tendon tissue under regional or general anesthesia. The workflow includes preoperative evaluation and consent, intraoperative documentation of the anatomical structures treated (bursa, synovium, tendons), operative report describing the extent of tissue removal, and postoperative instructions with rehabilitation referrals.

Coding Specifications

The service type is open extensive debridement with synovectomy and bursal/tendon involvement. The typical site of service is an operating room or ambulatory surgery center.

Modifier	Description	When to Use
`59`	Distinct procedural service	When a separate, distinct procedure is performed at a different site or session from another covered procedure.

CPT 25076: Excision of Deep Soft Tissue/Muscle Mass of Forearm or Wrist

CPT-25100-WRIST-JOINT-BIOPSY-INCISION

CPT 25100: Incision and Biopsy of Wrist Joint

CPT-25075-FOREARM-WRIST-SUBCUTANEOUS-MASS-EXCISION-3CM-OR-LESS

CPT 25075: Excision of Subcutaneous Forearm or Wrist Mass, ≤3 cm

CPT-25065-FOREARM-WRIST-SUPERFICIAL-SOFT-TISSUE-EXCISIONAL-BIOPSY

CPT 25065: Excisional Biopsy of Superficial Soft Tissue, Forearm/Wrist

CPT-25118-EXTENSOR-TENDON-SHEATH-SYNOVECTOMY-WRIST-COMPARTMENT

CPT 25118: Extensor Tendon Sheath Synovectomy, Wrist Compartment

CPT-25150-FOCAL-BONE-EXCISION-SAUCERIZATION

CPT 25150: Focal Bone Excision (Saucerization)

25111-EXCISION-OF-GANGLION-WRIST-DORSAL-OR

CPT 25111: Excision of Wrist Ganglion (Dorsal or Volar)

CPT-25215-PROXIMAL-ROW-CARPIECTOMY-WRIST-SURGERY

CPT 25215: Proximal Row Carpectomy (Wrist Surgery)

CPT-25105-WRIST-SYNOVECTOMY-SURGICAL-SYNOVIAL-EXCISION

CPT 25105: Wrist Synovectomy, Surgical Excision of Synovium

CPT-25170-FOREARM-BONE-TUMOR-EXCISION-RADIUS-ULNA

CPT 25170: Excision of Tumor of Radius or Ulna

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Taxonomy Code	Specialty	Notes
207LH0000X	Orthopaedic Hand Surgery	Primary specialty performing extensive synovectomy and tendon/bursa debridement.
207T00000X	Orthopaedic Surgery	General orthopedists who perform hand and wrist surgical procedures.
231H00000X	Plastic Surgery - Hand Surgery	Plastic surgeons with hand subspecialty performing complex soft tissue and tendon work.
208600000X	General Surgery	Occasionally involved in complex soft-tissue debridement in multi-disciplinary settings.
390200000X	Anesthesiology	Provides regional or general anesthesia for the operative procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M65.4`	Radial styloid tenosynovitis (De Quervain)	Tenosynovitis causing synovial proliferation and painful tendon sheath requiring synovectomy.
`M65.8`	Other synovitis and tenosynovitis	Captures other specific tenosynovitis forms that may require extensive debridement.
`M71.2`	Bursitis of wrist and hand	Inflamed bursa involvement that may necessitate bursal excision during the procedure.
`M19.041`	Primary osteoarthritis, right wrist	Degenerative joint disease causing secondary synovial inflammation and tendon pathology.
`M67.4`	Ganglion of joint or tendon	Ganglion-associated tenosynovitis or mass effect that prompts excision along with synovectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`25070`	Excision, tumor, or other lesion, deep, of forearm or wrist	May be used when an excision of a discrete lesion accompanies synovectomy or bursal removal.
`25295`	Repair, extensor tendon, wrist, primary; with graft when performed	Related when tendon repair or reconstruction is required after debridement of diseased tendon tissue.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder)	Performed preoperatively for diagnostic or therapeutic aspiration of inflamed bursa or synovial fluid.
`29848`	Arthroscopy, wrist, surgical; synovectomy, debridement	Minimally invasive alternative when arthroscopic synovectomy is feasible; may be performed before or instead of open `25115`.
`99024`	Postoperative follow-up visit global period, same physician	Used for postoperative global period follow-up visits in the global surgical package.

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