Summary & Overview
CPT 24071: Excision of Subcutaneous Tumor, Upper Arm/Elbow >3 cm
CPT code 24071 identifies the surgical excision of a subcutaneous tumor larger than 3 cm in the upper arm or elbow region. This code is used to bill for focused soft-tissue oncologic procedures involving removal of superficial masses in the distal arm. It matters nationally because such excisions are common in ambulatory surgical care and intersect with policy areas including surgical reimbursement, outpatient utilization, and coding specificity for oncologic procedures.
Key payers included in the overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of how the code is used in clinical billing, where the procedure is typically performed, and which payer types commonly reimburse for this service. The publication covers benchmark considerations for utilization and allowed amounts, highlights clinical context for appropriate coding, and notes common billing modifiers and administrative issues where data are available. Data not provided in the input—such as specific ICD-10 pairings, payer-specific edits, and associated taxonomies—is noted as not available in the input. The piece is intended for national audiences including revenue cycle managers, surgical clinicians, and policy analysts seeking a clear description of the code, typical sites of service, and the payer landscape relevant to CPT code 24071.
Billing Code Overview
CPT code 24071 describes the surgical removal of a tumor greater than 3 cm located in the subcutaneous tissue of the upper arm or elbow region. This procedure is a minor soft-tissue oncologic excision focused on the superficial tissues overlying the distal humerus and proximal forearm.
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Service type: Surgical excision of a subcutaneous tumor (greater than 3 cm)
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Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be performed in an operating room depending on clinical complexity and anesthesia needs.
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents to the outpatient surgical clinic with a progressively enlarging, palpable subcutaneous mass on the lateral aspect of the right upper arm measuring approximately 4.0 cm by clinical exam and ultrasound. The mass is well-circumscribed, mobile, and causing intermittent discomfort with shoulder motion. After history, physical exam, and imaging suggest a benign-appearing soft tissue tumor in the subcutaneous tissue, the patient is scheduled for an excision under monitored anesthesia care in an ambulatory surgery center. The clinical workflow includes preoperative evaluation and consent, lesion localization and marking, intraoperative sterile preparation, excision of the tumor with appropriate margins and hemostasis, specimen labeling and submission to pathology, wound closure, and routine postoperative instructions. Typical follow-up occurs in the clinic within 7–14 days for wound check and pathology review. Common payors for reimbursement and claims processing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left upper arm/elbow area |
RT |