Summary & Overview
CPT 23145: Excision of Benign Bone Lesion of Clavicle or Scapula with Graft
CPT code 23145 represents excision or curettage of a benign bone lesion of the clavicle or scapula with autologous bone grafting and submission of the specimen for pathological analysis. This operative code captures a combined surgical and reconstructive service commonly performed by orthopedic or orthopedic oncology surgeons to remove symptomatic or structurally significant nonmalignant masses that involve the collarbone or shoulder blade.
Nationally, the code matters because it documents a resource-intensive procedure involving operative time, graft harvest, and pathology services—components that affect hospital and payer reimbursement and utilization tracking. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical scope of the code, expected setting of care, and the procedural elements that drive coding and billing complexity. The publication provides benchmarks and payment context, highlights policy considerations that influence coverage determinations, and summarizes clinical indications and documentation elements relevant to proper coding. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 23145 describes the surgical removal of a benign (noncancerous) mass or cyst from the clavicle (collarbone) or scapula (shoulder blade) by excising or scraping the involved bone. The procedure includes filling the resulting bony defect with autologous bone graft harvested from the same patient and submission of the excised specimen to a laboratory for analysis.
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Service type: Surgical excision with bone grafting and specimen submission
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with a painful, enlarging benign osseous lesion of the clavicle identified on radiographs and MRI. The orthopedic surgeon schedules an operative procedure to remove the noncancerous bone lesion via curettage and excision of the involved portion of the clavicle or scapula, harvest autogenous bone graft from the iliac crest, pack the bone defect with the graft, and send curetted tissue to pathology for histologic analysis. The typical workflow includes preoperative imaging and surgical consent, intraoperative general anesthesia, operative removal of the lesion and defect reconstruction with autograft, specimen submission to the lab under a surgical pathology request, postoperative recovery in the ambulatory surgery center or inpatient hospital depending on comorbidity, and routine postoperative follow-up with wound and functional assessment. The typical site of service is an outpatient ambulatory surgery center or inpatient hospital operating room depending on complexity and patient medical status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When identical procedure is performed on both clavicles or both scapulae during same session |
51 | Multiple procedures |