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.
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Associated Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
207X00000X | Orthopaedic Surgery Physician |
207XS0117X | Orthopaedic Surgery of the Hand Physician |
207XX0004X | Hand Surgery Physician |
Related Diagnoses
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M67.431— Ganglion, right wrist- Clinical relevance: Identifies a ganglion localized to the right wrist as the operative indication for
25111when the right wrist is treated.
- Clinical relevance: Identifies a ganglion localized to the right wrist as the operative indication for
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M67.432— Ganglion, left wrist- Clinical relevance: Identifies a ganglion localized to the left wrist as the operative indication for
25111when the left wrist is treated.
- Clinical relevance: Identifies a ganglion localized to the left wrist as the operative indication for
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M67.439— Ganglion, unspecified wrist- Clinical relevance: Used when the wrist is specified as the site but laterality is not documented; supports
25111when the procedure site is documented as wrist without laterality.
- Clinical relevance: Used when the wrist is specified as the site but laterality is not documented; supports
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M67.40— Ganglion, unspecified site- Clinical relevance: Used when a ganglion diagnosis is documented but the anatomical site is not specified; additional documentation is generally needed to support use of
25111which is site-specific.
- Clinical relevance: Used when a ganglion diagnosis is documented but the anatomical site is not specified; additional documentation is generally needed to support use of
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M67.44— Ganglion, hand- Clinical relevance: Indicates a ganglion located in the hand rather than specifically the wrist; may be relevant if the ganglion involves the hand adjacent to the wrist and documentation supports use of
25111.
- Clinical relevance: Indicates a ganglion located in the hand rather than specifically the wrist; may be relevant if the ganglion involves the hand adjacent to the wrist and documentation supports use of
Related CPT Codes
| CPT Code | Description | Relationship to 25111 |
|---|---|---|
25112 | Excision of ganglion, wrist (dorsal or volar), repeat or multiple separate ganglia | Used when multiple separate ganglia are excised in the same session; may be billed for additional ganglia instead of repeating 25111. Commonly used together when multiple sites are treated. |
25115 | Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis) | Represents a more extensive radical excision of synovial tissue; an alternative when underlying synovial disease requires broader resection instead of a simple ganglion excision. |
25118 | Synovectomy, extensor tendon sheath, wrist, single compartment | Performed for tenosynovitis of extensor compartments; may be performed in the same operative session if both synovial disease and a ganglion are addressed, and coding should reflect distinct services or multiple procedures as appropriate. |
National Reimbursement Benchmarks
Medicare mean allowed rate ($329.82) is slightly below the BUCA (average commercial) mean ($438.56), indicating commercial payers on average reimburse more than Medicare for CPT 25111. The gap between Medicare and BUCA is $108.74, with Medicare clustered narrowly around its median compared with broader commercial variation.
Dispersion measured as the interquartile range (P75−P25) varies across payers: UnitedHealth Group has the widest spread at $334.00 (P75 $698 − P25 $364), followed by Cigna at $313.00, while Medicare is the tightest at $34.00. Aetna and BUCA show moderate dispersion ($208.53 and $225.75 respectively), and Blue Cross Blue Shield sits between those groups with a $172.00 spread. The table and chart below present the full payer breakdown of mean and percentile rates.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.