Summary & Overview
CPT 24125: Radius Bone Cyst or Benign Tumor Excision with Autograft
CPT code 24125 denotes surgical excision of a benign bone cyst or noncancerous tumor from the radius with reconstruction using autogenous bone graft. This code captures a combined procedure—lesion removal plus grafting from the patient—and matters nationally because it affects surgical coding, reimbursement, and utilization patterns in orthopedic oncology and upper-extremity surgery. Proper use of the code aligns clinical documentation with billing for complex procedures that address structural defects after lesion removal.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find guidance on the clinical context for when CPT code 24125 applies, common sites of service, and what to expect in claims scenarios. The publication outlines benchmarks for coding practices, summarizes relevant payer coverage considerations, and highlights policy and documentation issues that commonly affect reimbursement for combined excision-and-grafting procedures. Where specific payer policy details are not available in the input, the text notes that data are not available.
This summary is intended for national audiences—including coders, billing managers, and orthopedic clinicians—seeking a concise overview of the code’s clinical meaning, typical settings, and the payer landscape relevant to CPT code 24125.
Billing Code Overview
CPT code 24125 describes surgical excision of a bone cyst or benign (noncancerous) tumor from the radius with placement of grafting material harvested from the patient (autograft). This procedure involves removal of the lesion and reconstruction of the resulting bony defect using the patient’s own bone graft.
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Service type: Orthopedic surgical procedure — tumor/cyst excision with autogenous bone grafting
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Typical site of service: Hospital operating room or ambulatory surgical center, often performed by an orthopedic surgeon or hand/upper-extremity specialist
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 24-year-old otherwise healthy male presents with persistent distal radial pain and progressive swelling after a minor forearm injury. Imaging (radiographs and MRI) demonstrates a unicameral bone cyst within the metaphyseal region of the radius with cortical thinning but no evidence of malignancy. Conservative measures have failed and the lesion places the patient at risk for pathologic fracture. The orthopedic surgeon schedules operative management: curettage and excision of the benign bone cyst from the radius, harvest of autologous bone graft (commonly from the iliac crest), and placement of grafting material to fill the defect. The perioperative workflow includes preoperative consent, anesthesia evaluation (general or regional), intraoperative fluoroscopic localization, cyst excision and defect preparation, autograft harvest, graft placement, hemostasis, and postoperative immobilization with a splint or cast.
Clinical documentation should include the site and laterality of the radius lesion, indication for excision (e.g., symptomatic cyst, risk of fracture), description of graft source and volume harvested, intraoperative findings, estimated blood loss, anesthesia type, and any intraoperative complications. Operative reports and anesthesia records support coding for the excision with grafting and for any additional services such as graft harvest or intraoperative imaging.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified — not typically used in claims |