2025 CPT code 21556
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision of Soft Tissue Tumors Musculoskeletal System Feed
Excision of a subfascial (e.g., intramuscular) soft tissue tumor in the neck or anterior thorax, less than 5 cm.
Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 51 (multiple procedures) may be used if multiple procedures are performed on the same day. Modifier 76 (repeat procedure by the same physician) may be used if the procedure is repeated by the same physician.
Surgical excision is medically necessary when a patient presents with a symptomatic mass in the neck or anterior thorax that is potentially malignant or significantly compromises the surrounding tissue.The diagnosis should be based on clinical examination and appropriate imaging.
The surgeon's responsibilities include preoperative planning, appropriate patient preparation and anesthesia administration, surgical excision of the tumor with meticulous dissection to preserve vital structures, hemostasis (control of bleeding), wound irrigation, placement of drains if needed, and layered wound closure.Postoperative care instructions and follow-up are also part of the clinical responsibility.
In simple words: The doctor removes a growth (tumor) from the muscle tissue of the neck or upper chest.The growth is less than 5 centimeters across. The doctor removes the growth with a small amount of surrounding tissue.
This CPT code, 21556, represents the surgical excision of a benign or malignant soft tissue tumor located in the subfascial (e.g., intramuscular) region of the neck or anterior thorax.The tumor's greatest diameter, including the margins necessary for complete excision, must be less than 5 centimeters. The procedure encompasses dissection and elevation of tissue planes to facilitate tumor resection, but does not include significant removal of surrounding normal tissue.Appreciable vessel exploration/neuroplasty and complex repairs are separately reported.
Example 1: A 45-year-old male presents with a palpable 4 cm mass in his right sternocleidomastoid muscle.The mass is excised completely, pathology reveals a benign fibroma., A 60-year-old female presents with a rapidly growing 3 cm mass in her pectoral muscle. A biopsy confirms a malignant sarcoma. Surgical excision, code 21556, is performed, followed by adjuvant therapies., A 20-year-old male sustains a penetrating injury to the neck during a motor vehicle accident, resulting in a subfascial hematoma that requires surgical debridement and evacuation.The surgeon excises necrotic tissue and addresses associated soft tissue injury.
** Always verify code appropriateness based on the individual patient's clinical circumstances and payer guidelines. The size of the tumor should be measured at the time of excision and should include margins of excision.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: This information is not available in the provided source.Refer to the AMA's CPT codebook or other relevant payment resources for RVU data.
- Global Days : The global period for this procedure is not explicitly stated in the provided sources. The global period varies depending on the payer and the specific circumstances of the procedure.
- Payment Status: Active
- Modifier TC rule: The information on whether a Technical Component (TC) modifier is applicable is not explicitly provided within the source.Consult the appropriate CPT guidelines for further information on modifier usage in this context.
- Fee Schedule : The historical fee schedules are not available in this source. Consult your payer's fee schedule for the appropriate reimbursement amounts for this procedure.
- Specialties:General Surgery, Plastic Surgery, Otolaryngology
- Place of Service:Office, Ambulatory Surgical Center, Hospital Outpatient Department