2025 CPT code 23071

Excision of a subcutaneous soft tissue tumor in the shoulder area, 3 cm or greater.

Refer to the most up-to-date CPT manual and related coding guidelines for complete information on appropriate code selection and reporting guidelines for this procedure.Pay particular attention to the guidelines related to measurement and inclusion/exclusion criteria.

Modifiers may be applicable depending on the circumstances of the procedure. Examples include modifiers for multiple procedures (51), bilateral procedures (50), assistant surgeons (80, 81, 82), etc.Refer to the CPT manual for appropriate modifier usage.

Medical necessity for excision of a subcutaneous soft tissue tumor is established when the lesion is symptomatic or poses a cosmetic concern.Malignancy or suspicion of malignancy also justifies excision. Documentation must support the clinical indication for the procedure.

The physician or qualified healthcare professional is responsible for all aspects of the procedure, including patient preparation and anesthesia, surgical excision of the tumor and surrounding margin, wound irrigation, and closure.The physician also submits the excised tissue for pathological analysis and interprets the results.Any additional services (such as those mentioned in alternate codes notes) are the responsibility of the physician performing those services.

IMPORTANT For excision of benign lesions of cutaneous origin (e.g., sebaceous cyst), see codes 11400-11446.Codes for radical resection (with wide margins) should be used for malignant tumors or aggressive benign tumors.Separate codes are needed for appreciable vessel exploration and/or neuroplasty, complex repair techniques (extensive undermining), and other related procedures.

In simple words: The doctor removes a lump (tumor) from under the skin in the shoulder area. The lump must be at least 3 centimeters across to use this code. The doctor sends the lump to a lab for testing.

This CPT code represents the excision of a benign or malignant subcutaneous soft tissue tumor located in the shoulder area.The procedure involves the removal of the tumor and a margin of surrounding tissue. The greatest diameter of the tumor plus the margin must measure 3 cm or greater for this code to be applicable.Microdissection may be used.Appreciable vessel exploration and/or neuroplasty should be reported separately.Extensive undermining or other complex repair techniques should also be reported separately.The excised tissue is sent for pathological analysis.

Example 1: A 55-year-old male presents with a 4cm subcutaneous lipoma on his right shoulder. The surgeon performs an excision of the lipoma with a 1cm margin. The specimen is sent to pathology for confirmation. The wound is closed with sutures., A 70-year-old female presents with a 3.5cm subcutaneous nodular lesion on her left shoulder.A biopsy is performed. Pathological analysis reveals a malignant fibrous histiocytoma.A wider excision is performed with a 2cm margin. The surgical margins are sent to pathology and are negative., A 30-year-old male presents with a 5cm subcutaneous mass on his left shoulder. The mass is excised with a 1cm margin. Significant bleeding occurs during the procedure, requiring vessel exploration and ligation. The wound is closed with layered sutures.

** Always verify code selection with the most current CPT guidelines and payer-specific requirements.The description provided is for informational purposes and should not be considered exhaustive.Consult official coding resources for complete and accurate information.

  • Revenue Code: P5E (Ambulatory Procedures - Other)
  • RVU: This information varies based on geographic location and payer. Consult your local Medicare fee schedule and other payer-specific information for accurate RVU and reimbursement data.
  • Global Days : The global period for this procedure varies depending on the payer.Information regarding the specific global period must be obtained from the relevant payer's guidelines.
  • Payment Status: Active
  • Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
  • Fee Schedule : Fee schedules vary greatly by payer and location.Check your local Medicare fee schedule and other payer-specific fee schedules for historical data.This information is not readily available through this response.
  • Specialties:Surgical Oncology, General Surgery, Plastic Surgery, Orthopedic Surgery
  • Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)
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