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CPT 23077: Extensive Excision of Malignant Soft Tissue Tumor, Shoulder
CPT code 23077 denotes an extensive surgical excision of a malignant soft tissue tumor in the shoulder region when the tumor and required margins are under 5 cm. This code captures procedures that extend beyond simple tumor removal to include surrounding tissues and anatomical structures suspected of involvement. The code is relevant nationally for surgical oncology, orthopedic oncology, and general orthopedic services and carries implications for operative planning, anesthesia, site of service selection, and payer coverage policies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service expectations, payer coverage scope, common billing considerations, and typical sites of service. The publication also highlights benchmarks for utilization, coding nuances relevant to shoulder soft tissue sarcoma excisions, and recent policy updates affecting surgical oncology billing where available.
This summary is intended to orient clinicians, coding professionals, and policy analysts to the clinical intent and billing context of CPT code 23077, provide national-level payer coverage context, and identify the primary areas to review when preparing claims or evaluating reimbursement policy. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 23077 describes an extensive excision of a soft tissue malignant tumor (such as a sarcoma) from the shoulder region. The procedure entails removal of the tumor plus surrounding tissue and anatomical structures suspected of involvement, with the combined tumor diameter and required margins measuring less than 5 cm.
Service Type: Surgical excision of malignant soft tissue tumor (extensive)
Typical Site of Service: Hospital operating room or ambulatory surgical center (shoulder/upper extremity surgical service)