CPT 25071 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 25071: Excision of Soft-Tissue Mass, Forearm or Wrist (≥3 cm)

CPT code 25071 denotes the surgical excision of a soft-tissue mass beneath the skin of the forearm or wrist when the specimen is 3 cm or larger and is submitted for pathological analysis. This procedure-level code captures a common outpatient surgical intervention used to diagnose or treat palpable masses in the distal upper extremity. It matters nationally because it affects perioperative coding, billing consistency, and claims adjudication across both commercial and public payers.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and coding context for when 25071 is reported, plus what to expect for sites of service and typical clinical use. The publication summarizes benchmarks and payment considerations, highlights common billing modifiers, and outlines relevant clinical context for specimen submission for pathology.

The content is intended for coding professionals, surgical providers, and revenue-cycle staff seeking clear guidance on the clinical circumstances represented by CPT code 25071, common payer coverage patterns, and the operational steps tied to specimen handling and outpatient surgical workflows.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 25071soft tissue excisionforearm surgerywrist procedureoutpatient surgerypathology specimensurgical codingprocedure coding

Billing Code Overview

CPT code 25071 describes the surgical excision of a mass located in the soft tissues beneath the skin of the forearm or wrist, with the excised specimen measuring 3 cm or greater in greatest dimension and submitted for laboratory analysis to determine its nature.

Service type: Surgical excision of soft tissue mass
Typical site of service: Ambulatory surgical center or hospital outpatient setting; may also occur in an office-based surgical suite depending on provider resources and case complexity.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 45-year-old right-hand–dominant patient presents to an outpatient ambulatory surgery center with a 3.5 cm, palpable, slowly enlarging subcutaneous mass on the dorsal aspect of the left forearm. The lesion is mobile relative to deeper structures, intermittently tender, and increasing in size; ultrasound suggests a cystic or soft-tissue tumor. After evaluation by a hand/orthopedic surgeon, the patient is scheduled for excision of the soft-tissue mass under monitored anesthesia care with local/regional anesthesia. The provider performs a skin incision over the mass, dissects through subcutaneous tissue to the lesion, excises the specimen intact (measuring >3 cm), controls hemostasis, closes the wound, and submits the specimen to surgical pathology for histologic and possible immunohistochemical analysis to determine etiologic diagnosis. Typical workflow steps include preoperative consent and site marking, intraoperative specimen orientation and labeling, submission of requisition with clinical history, postoperative wound care instructions, and documentation of operative findings, specimen size (>3 cm), and disposition. Typical site of service is an ambulatory surgery center or hospital outpatient department; the service type is minor surgical excision of a deep subcutaneous/soft-tissue mass of the forearm or wrist.

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use when the procedure is performed on the right forearm or wrist.

CPT 25107: Open Wrist Surgery for TFCC Repair or Debridement

CPT-25118-EXTENSOR-TENDON-SHEATH-SYNOVECTOMY-WRIST-COMPARTMENT

CPT 25118: Extensor Tendon Sheath Synovectomy, Wrist Compartment

CPT-25145-FOREARM-WRIST-SEQUESTRECTOMY-REMOVAL-DEAD-BONE

CPT 25145: Removal of Separated Dead Bone, Forearm or Wrist

CPT-25109-FOREARM-WRIST-TENDON-EXCISION

CPT 25109: Tendon Excision, Forearm/Wrist

CPT-25105-WRIST-SYNOVECTOMY-SURGICAL-SYNOVIAL-EXCISION

CPT 25105: Wrist Synovectomy, Surgical Excision of Synovium

CPT-25136-CARPAL-BONE-EXCISION-WITH-ALLOGRAFT-RECONSTRUCTION

CPT 25136: Carpal Bone Excision with Allograft Reconstruction

CPT-25085-WRIST-JOINT-CAPSULOTOMY-RELEASE-CONTRACTURE

CPT 25085: Wrist Joint Capsule Release (Capsulotomy)

CPT-25110-TENDON-SHEATH-LESION-EXCISION-FOREARM-WRIST

CPT 25110: Excision of Lesion from Tendon Sheath, Forearm or Wrist

CPT-25125-EXCISION-BONE-LESION-RADIUS-ULNA-WITH-AUTOGRAFT-REPAIR

CPT 25125: Excision of Benign Bone Lesion of Radius/Ulna with Autograft Repair

CPT-25076-FOREARM-WRIST-DEEP-SOFT-TISSUE-MASS-EXCISION-3CM-OR-LESS

CPT 25076: Excision of Deep Soft Tissue/Muscle Mass of Forearm or Wrist

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Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopedic Surgery	Common specialty performing soft-tissue mass excisions of forearm and wrist.
`208U00000X`	General Surgery	General surgeons perform superficial and some deep soft-tissue mass excisions.
`207W00000X`	Hand Surgery	Hand surgeons or orthopedic hand specialists commonly manage forearm/wrist masses, particularly near neurovascular structures.
`207RH0000X`	Plastic Surgery	Plastic surgeons perform soft-tissue excisions when reconstruction or complex closure is anticipated.
`363A00000X`	Dermatology	Dermatologic surgeons may perform excisions of subcutaneous masses when superficial or skin-involving.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`25072`	Excision, tumor, soft tissue of forearm and/or wrist, subcutaneous; 1.1 cm to 3.0 cm	Represents the adjacent size-based code for smaller lesions; used when the specimen measures between 1.1 and 3.0 cm instead of ≥3 cm.
`11402`	Excision, benign lesion including margins, trunk, arms or legs; excised diameter 1.1 to 2.0 cm	Alternative for superficial benign skin lesions of the forearm when the lesion is primarily cutaneous rather than subcutaneous soft-tissue mass.
`11406`	Excision, benign lesion including margins, trunk, arms or legs; excised diameter over 4.0 cm	Used when larger cutaneous lesions require excision with margins; applicable when skin excision dominates the procedure rather than subcutaneous mass removal.
`11200`	Removal of skin tags, multiple fibro-epithelial tags, any area; up to and including 15 lesions	Performed for small superficial lesions occurring concomitantly but not typically used for deep soft-tissue masses.
`20220`	Excision of lesion of mandible; not directly related	Data not available in the input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M79.1`	Myalgia	May be used when mass is associated with localized muscle pain; less specific but sometimes listed when pain is a primary symptom.
`D48.9`	Neoplasm of uncertain behavior, unspecified	Used when the mass is excised and nature is uncertain pending pathology.
`M67.40`	Bursa or tendon sheath cyst, unspecified site	Relevant for ganglion or synovial cysts of the wrist/forearm that may present as subcutaneous masses.
`D21.9`	Benign neoplasm of connective and other soft tissue, unspecified	Common diagnosis when a benign lipoma or other soft-tissue tumor is suspected preoperatively.
`S60.31XA`	Contusion of forearm, initial encounter	Used when mass or swelling is related to prior trauma presenting as a mass; generally less common but clinically plausible.

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