CPT 23140 Reimbursement & Policy Benchmarks

CPT code 23140 denotes surgical excision or scraping (curettage) of a benign bone mass or cyst located at the clavicle or scapula, with submission of the specimen for laboratory analysis. This code captures a focused orthopedic procedure to remove noncancerous osseous lesions and is relevant to surgeons, hospital billing departments, and payers nationwide because it affects surgical coding, facility utilization, and pathology services. Key payers considered in this context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service represented by the code, common sites of service, and the role of pathology specimen submission. The publication also outlines payer coverage considerations, common modifiers in use for related surgical services, and coding relationships to other musculoskeletal and surgical CPT codes. Clinicians and billing professionals will gain clarity on procedural scope, documentation touchpoints that typically support use of this code, and areas where policy updates or payer-specific rules frequently affect claim processing. Data not available in the input is noted where applicable.

Billing Code Overview

CPT code 23140 describes the surgical removal of a noncancerous mass or cyst from the clavicle (collar bone) or scapula (shoulder blade) by excising or scraping the bone. The procedure includes submission of the tissue specimen to a laboratory for analysis.

Service type: Surgical excision/osseous curettage of benign bone lesion
Typical site of service: Hospital outpatient department or ambulatory surgery center; may also be performed in an operating room setting when clinically indicated

Data not available in the input.

Clinical Context

A 48-year-old patient presents to an orthopedic clinic with a slowly enlarging, painful palpable mass over the lateral aspect of the clavicle near the acromioclavicular joint. Imaging with plain radiography and CT demonstrates a nonmalignant osseous or cartilaginous cystic lesion adherent to the clavicle with cortical irregularity but no aggressive features. Conservative management failed to relieve pain and dysfunction. The orthopedic surgeon schedules an operative procedure under general anesthesia in an ambulatory surgery center to perform excision and/or curettage of the benign bone lesion of the clavicle. Intraoperatively the surgeon removes the lesion by scraping and excising affected cortical bone, controls bleeding, and submits the specimen as forwarded tissue to the pathology laboratory for histopathologic analysis. The patient is monitored in recovery and discharged with wound care instructions and follow-up for pathology results and rehabilitative guidance.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical (extensive dissection, prolonged operative time).
`26`	Professional component

Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopaedic Surgery	Most common specialty performing clavicle/shoulder bone excisions and curettage.
`207RH0000X`	Hand Surgery (Orthopedic Hand)	May perform if lesion involves distal clavicle AC joint with need for specialized joint reconstruction.
`208000000X`	General Surgery	Occasionally involved for access or combined approaches in complex chest wall lesions.
`207K00000X`	Orthopaedic Sports Medicine	Performs procedures related to shoulder girdle pathologies impacting function and athletes.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M85.8`	Other specified disorders of bone density and structure	May capture benign, unspecified focal bone lesions requiring curettage or excision.
`M89.8`	Other specified disorders of bone	Used for focal benign bone pathologies not otherwise specified that prompt surgical removal.
`D16.9`	Benign neoplasm of bone, unspecified	Common code for benign bone tumors (e.g., osteochondroma, enchondroma) of clavicle or scapula needing excision.
`M27.8`	Other disorders of the jaw and facial bones — code used analogously for osseous lesions; included for breadth	May be used when standard codes for shoulder girdle bone lesions are not specific; clinical use depends on payer rules.
`M79.6`	Pain in limb	Symptom code sometimes reported alongside definitive diagnosis when pain is a primary indication for excision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`23140`	Excision or curettage of lesion or cyst of clavicle or scapula; includes submission of specimen for analysis	Primary procedure: removal of a benign bone mass from clavicle/shoulder blade with specimen sent to pathology.
`11042`	Debridement; skin, subcutaneous tissue and muscle, first 20 sq cm or less	May be used if debridement of overlying soft tissue or infected tissue is required in the same operative session.
`27389`	Resection, clavicle, partial	Used when a partial claviculectomy is performed for access or to remove a lesion involving the clavicular shaft.
`20220`	Excision of benign tumor or cyst of facial bones; complicated — not directly related anatomically but analogous code for bone tumor excision	Demonstrates coding for benign bone tumor excision when anatomical-specific codes are needed; used as reference when adjacent bone structures are involved.
`88305`	Level IV surgical pathology, gross and microscopic examination	Used by the pathology laboratory to bill examination of the submitted specimen after excision.

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Summary & Overview

CPT 23140: Excision of Benign Bone Mass or Cyst, Clavicle/Scapula