2025 CPT code 21552
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Surgery Feed
Excision of a subcutaneous soft tissue tumor in the neck or anterior thorax, 3 cm or greater.
Modifiers may be applicable based on the circumstances of the procedure.Refer to CPT guidelines and payer-specific instructions for modifier usage.
Medical necessity for excision is established when the lesion is symptomatic (pain, cosmetic concern), or if there is concern for malignancy.Documentation must support the need for the procedure based on the patient's clinical presentation and the characteristics of the lesion.
The physician or qualified healthcare professional is responsible for the pre-operative assessment, obtaining informed consent, performing the excision, ensuring hemostasis, and closing the incision. Post-operative care may be included within the global surgery period or billed separately based on payer guidelines.
In simple words: The doctor removes a growth (lump) from just under the skin of the neck or upper chest. The lump is 3 centimeters or larger. The doctor sends a sample to the lab to confirm the diagnosis.
Excision of a subcutaneous soft tissue tumor (benign or malignant) from the neck or anterior thorax measuring 3 centimeters or more in greatest dimension.The procedure involves incision, dissection to free the mass, removal of the tumor, irrigation, hemostasis, and layered closure.Appreciable vessel exploration or neuroplasty, if performed, are coded separately.Extensive undermining or complex repair to close the defect, should they be necessary, are also separately reported.
Example 1: A 55-year-old male presents with a 4cm subcutaneous mass in the anterior neck.The mass is excised, and pathology confirms a lipoma., A 32-year-old female presents with a 3.5cm subcutaneous mass in the anterior chest.The mass is excised, pathology reveals a fibroma.The patient requires a simple closure., A 70-year-old male presents with a 5cm subcutaneous mass in the right submandibular region.The mass is excised; a significant vessel is encountered and repaired during the procedure.The resulting defect requires extensive undermining and a complex closure.
* Preoperative and postoperative diagnoses* Location and size of the mass.* Description of the surgical procedure.* Pathology report* Operative note with details of any complications, such as vessel injury or need for complex closure.
** Always confirm payer-specific guidelines and coding requirements before submitting claims.Use of this code requires comprehensive documentation to support medical necessity and accurate coding.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: Information not available in provided text. Refer to CMS guidelines and local payer policies for RVU values and reimbursement rates.
- Global Days : Information not available in provided text. Refer to global surgery guidelines for this specific CPT code.
- Payment Status: Active
- Modifier TC rule: Not applicable for this code.
- Fee Schedule : Information not available in provided text.Refer to historical fee schedules for relevant data.
- Specialties:Surgical Oncology, General Surgery, Plastic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)