Summary & Overview

CPT 23210: Radical Resection of Tumor, Scapula

CPT code 23210 represents a radical resection of a tumor of the scapula with submission of the specimen for laboratory analysis. This code captures a major oncologic orthopedic procedure used when primary bone malignancies or locally advanced soft-tissue tumors require extensive surgical removal. It is clinically significant because it records an operative intervention that affects staging, adjuvant therapy decisions, functional outcomes, and resource use across surgical and pathology services.

Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national benchmarks for utilization and payment patterns, discussion of clinical context for tumor resection of the shoulder girdle, and coverage considerations relevant to major orthopedic-oncologic procedures. The publication also outlines common coding intricacies and service-line implications for surgical departments and pathology services.

This summary provides a concise reference for clinicians, coding professionals, and policy analysts seeking to understand how CPT code 23210 is used to document radical scapular tumor resections, where the service is typically delivered, and which payers commonly adjudicate claims for this high-acuity surgical procedure. Data not available in the input will be identified in supporting sections.

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Billing Code Overview

CPT code 23210 describes a radical resection of a tumor involving the scapula (shoulder blade) with submission of the surgical specimen to a laboratory for pathologic analysis. The procedure involves removal of the tumor and surrounding tissues to achieve oncologic control and obtain tissue for diagnostic and staging purposes.

Service Type: Surgical — oncologic resection

Typical Site of Service: Inpatient or outpatient surgical setting, commonly performed in an operating room at a hospital or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient presents with a progressively enlarging, painful mass over the scapular region. Imaging with MRI demonstrates a heterogeneous, deep soft-tissue lesion involving the scapula consistent with a suspected primary sarcoma or metastatic tumor. Core needle biopsy is nondiagnostic or confirms a malignant neoplasm requiring definitive management. The surgical team — typically an orthopedic oncologist or surgical oncologist — schedules a radical resection of the tumor with removal of involved scapular bone and adjacent soft tissues. The procedure may occur in an inpatient hospital operating room or an ambulatory surgical center depending on complexity and anticipated postoperative needs. The specimen is submitted to pathology for histologic typing, grading, and margins assessment. Perioperative workflow includes preoperative staging (imaging, labs), multidisciplinary tumor board review, intraoperative specimen handling with labeling and request for frozen section if margin assessment is needed, postoperative admission for pain control and wound monitoring when indicated, and coordination of adjuvant oncology care based on final pathology.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, complexity, or postoperative care substantially exceeds the typical service for radical resection of a scapular tumor.
`50`	Bilateral procedure	Use when identical radical resections are performed on both left and right scapulae (rare).
`51`	Multiple procedures	Use when other distinct surgical procedures are performed during the same operative session in addition to the radical scapular resection.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but halted for reasons unrelated to patient improvement or normal postoperative course.
`58`	Staged or related procedure or service by the same physician during the postoperative period	Use when the radical resection is planned as part of a staged approach and a subsequent related procedure is scheduled.
`62`	Two surgeons	Use when two surgeons work together as co-surgeons performing distinct, substantial portions of the operation.
`66`	Surgical team (more than two surgeons)	Use when multiple surgeons participate as a surgical team during a complex resection.
`78`	Unplanned return to the operating room for a related procedure during the postoperative period	Use when the patient requires an unplanned reoperation related to the original scapular tumor resection.
`79`	(Not listed in provided modifiers)	Data not available in the input.

Taxonomy Code	Specialty	Notes
208000000X	Orthopaedic Surgery	Orthopedic oncologists commonly perform radical resections of scapular and shoulder girdle tumors.
208600000X	Surgical Oncology	Surgical oncologists manage complex oncologic resections and coordinate pathology and adjuvant care.
207RH0000X	Otolaryngology — Head & Neck Surgery	May be involved if tumor extends to adjacent neck/shoulder structures (less common).
207L00000X	Plastic Surgery	Plastic and reconstructive surgeons often perform reconstruction, flap coverage, or soft-tissue reconstruction after radical resection.
363LF0000X	Pathology	Anatomic pathologists analyze the resected specimen for diagnosis, margin status, and staging.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C49.A9`	Malignant neoplasm of connective and soft tissue of unspecified site, upper limb, including shoulder girdle	Soft-tissue sarcoma involving the scapular region commonly necessitating radical resection.
`C41.2`	Malignant neoplasm of scapula and long bones of shoulder girdle	Primary bone sarcoma of the scapula requiring radical osseous resection.
`C79.51`	Secondary malignant neoplasm of bone	Metastatic disease to the scapula that may require surgical resection for local control or palliation.
`D48.6`	Neoplasm of uncertain behavior of other connective and soft tissue	Lesions of uncertain malignant potential may prompt excisional biopsy or definitive resection for diagnosis and treatment.
`M89.9`	Disorder of bone, unspecified	Non-neoplastic destructive bone conditions occasionally necessitating resection when diagnostic uncertainty exists.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`24102`	Radical resection of tumor, humerus; proximal or shaft, including partial or total humeral head resection when performed	May be performed when tumor involves proximal humerus adjacent to the scapula or shoulder girdle requiring combined resection.
`25122`	Radical resection of tumor, ulna; excision, en bloc	Example of analogous code for radical resections of long bones; included for coding context when multiple limb bones are involved.
`20924`	Tumor resection (e.g., desmoid tumor), deep, intramuscular or intermuscular, scapular region — complex soft-tissue tumor excision with flap closure	Pertinent when extensive soft-tissue resection with reconstruction is required alongside scapular bone removal.
`88307`	Surgical pathology, gross and microscopic examination, complex; e.g., bone and soft tissue tumor evaluation	Used by pathology for comprehensive evaluation of the resected scapular tumor specimen, including immunohistochemistry and special studies.
`27356`	Radical excision of tumor (e.g., malignant) of pelvis/hip region — listed as analogous pelvic girdle radical resection	Included as a related major musculoskeletal oncologic resection code when planning complex girdle resections.
`11042`	Debridement, subcutaneous tissue and fascia; first 20 sq cm or less	May be used when additional debridement of soft tissues is performed at the time of tumor resection.