2025 CPT code 21557
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision Procedures on the Neck (Soft Tissues) and Thorax Musculoskeletal System Feed
Radical resection of a tumor (e.g., sarcoma) in the neck or anterior thorax; less than 5 cm.
Modifiers may be applicable depending on the specific circumstances of the case. Consult the CPT manual for appropriate modifier usage.
Medical necessity for a radical resection is typically established when a malignant or aggressive benign soft tissue tumor is present.The extent of the resection is driven by the need to achieve clear surgical margins to prevent recurrence and improve prognosis.
The surgeon's responsibilities include preoperative assessment, surgical planning, performing the radical resection, ensuring adequate margins are taken, hemostasis, wound closure, and postoperative care.Pathology consultation is typically involved.
- Musculoskeletal System
- Musculoskeletal System; Excision Procedures on the Neck (Soft Tissues) and Thorax
In simple words: The doctor removes a cancerous tumor from the neck or chest area, taking out a significant amount of healthy tissue around it to ensure all the cancer is gone. The tumor and the surrounding area removed are less than 5 centimeters across.
This CPT code describes the surgical procedure of radical resection of a tumor, such as a sarcoma, located in the soft tissues of the neck or anterior thorax.The procedure involves the extensive removal of the tumor along with a wide margin of surrounding normal tissue. The greatest diameter of the tumor plus the margins required for complete excision measures less than 5 cm.Appreciable vessel exploration, neuroplasty, or complex repair are reported separately.This is typically performed for malignant or aggressive benign tumors.
Example 1: A 45-year-old male presents with a palpable mass in the right anterior neck. Imaging reveals a 4 cm sarcoma. The surgeon performs a radical resection of the tumor, removing a wide margin of surrounding tissue., A 60-year-old female is diagnosed with a 3 cm sarcoma in the left supraclavicular region. The surgeon performs a radical neck dissection including resection of the tumor and surrounding tissues., A 30-year-old male presents with a rapidly growing mass in the anterior chest wall suspected to be a sarcoma. A radical resection of the tumor is performed, measuring 4.5 cm with margins.
* Thorough history and physical examination.* Imaging studies (e.g., ultrasound, CT scan, MRI) demonstrating tumor location and size.* Pathology report confirming diagnosis and margins.* Operative report detailing the surgical technique and margins resected.* Postoperative progress notes.
** Accurate assessment of tumor size and margins is crucial for appropriate code selection.Consult with surgical oncology or related specialists if any uncertainties exist regarding code selection.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The RVUs will vary depending on geographic location and other factors.Consult the Medicare Physician Fee Schedule (MPFS) and Local Coverage Determinations (LCDs) for the most accurate and up-to-date information.National average reimbursement estimates are available but should not be solely relied upon.
- Global Days : The global period for this procedure will vary depending on payer and other factors.Consult payer specific guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Fee schedules vary by payer and geographic location, and historical data is subject to change. Consult payer-specific fee schedules and other resources to access the most accurate data.
- Specialties:Surgical Oncology, General Surgery, Otolaryngology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center