How much does Medicare pay for CPT 25115?

Medicare allowed an average of $656.34 per service and paid $519.24 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4790.90, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 25115?

Extensive removal of growth of soft tissue structures in palm side of wrist. It was billed 1,746 times to 1,600 Medicare beneficiaries by 59 providers in 2024.

Does 25115 pay differently in an office than a hospital?

Yes. The allowed amount averaged $840.17 in an office setting and $640.32 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 25115 most?

Hand Surgery, with 678 services from 19 clinicians. Next are Orthopedic Surgery, Ambulatory Surgical Center, Plastic and Reconstructive Surgery.

CPT 25115

Extensive removal of growth of soft tissue structures in palm side of wrist

$656.34Medicare-allowed amount per service, averaged across 1,746 services

Providers submitted

$4790.90

Asking price, not received

Medicare allowed

$656.34

The fee schedule figure

Medicare paid

$519.24

Balance is patient coinsurance

Providers submitted an average of $4790.90 for this code and Medicare allowed $656.34 — 7.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $519.24 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $840.17
Hospital / facility: $640.32

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 140 services were billed in an office setting and 1,606 in a facility.

Services: 1,746
Beneficiaries: 1,600
Providers billing it: 59
Total allowed: $1,145,970

What Medicare pays for CPT 25115

Across 1,746 services billed by 59 providers to 1,600 beneficiaries, Medicare allowed an average of $656.34 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 25115

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hand Surgery	678	631	$739.76	19
Orthopedic Surgery	486	435	$703.54	17
Ambulatory Surgical Center	457	422	$475.40	18
Plastic and Reconstructive Surgery	75	69	$717.39	4
General Surgery	50	43	$628.75	1

25115 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	348	$891.66	$592.56	8
Pennsylvania	316	$533.77	$440.85	10
Virginia	166	$479.48	$387.41	2
California	133	$691.03	$505.70	7
Louisiana	116	$619.45	$567.96	2
Florida	113	$666.15	$502.91	7
Michigan	105	$543.45	$418.83	4
Nevada	72	$537.60	$437.42	3
Arkansas	72	$642.58	$578.02	1
Massachusetts	67	$757.69	$590.99	3
New Jersey	55	$655.51	$473.65	2
Minnesota	54	$686.51	$565.63	2
Hawaii	21	$709.09	$526.17	1
Texas	19	$730.15	$594.51	1
Ohio	18	$565.20	$466.71	1
Kansas	16	$554.58	$446.45	1
Missouri	15	$622.23	$540.64	1
Georgia	14	$676.88	$565.24	1
Tennessee	13	$507.18	$439.40	1
South Carolina	13	$710.61	$600.29	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.