Summary & Overview
CPT 25076: Excision of Deep Soft Tissue/Muscle Mass of Forearm or Wrist
CPT code 25076 represents the surgical excision of an abnormal mass located in the deep soft tissues or within the muscle of the forearm or wrist, with the specimen submitted for pathology and measuring 3 cm or less. This procedure code is important nationally because it captures a specific subset of soft-tissue excisions that may involve more complex dissection than superficial lesion removals, affecting billing, coding specificity, and clinical documentation.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical context, common sites of service, and the typical service type associated with CPT code 25076.
The publication provides benchmarks and coding context relevant to surgical soft-tissue excisions, highlights payer coverage considerations, and summarizes policy and documentation elements that commonly affect adjudication for deep forearm or wrist mass excisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25076 describes the excision of an abnormal mass located in the deep soft tissues or within the muscle of the forearm or wrist, with the specimen submitted for laboratory analysis and measuring 3 cm or less. The procedure involves surgical removal of a discrete lesion beneath superficial tissues, potentially requiring dissection through muscular planes to achieve complete excision.
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Service type: Surgical excision of deep soft tissue/muscle mass
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Typical site of service: Operative suite or ambulatory surgery center; may also be performed in a hospital outpatient department depending on patient factors and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an outpatient orthopedic surgical clinic with a progressively enlarging, palpable mass in the volar soft tissues of the distal forearm near the wrist that has become painful with activity. Preoperative evaluation includes history, focused physical exam, and imaging (ultrasound or MRI) demonstrating a well-circumscribed 2.5 cm deep soft tissue lesion within the flexor compartment. The patient is scheduled for an operative excision under regional block or general anesthesia. Intraoperatively the surgeon performs an excision of the abnormal mass from deep soft tissue/muscle of the forearm/wrist, achieves hemostasis, and submits a specimen measuring 3 cm or less to the pathology laboratory for histologic analysis. The typical site of service is an ambulatory surgical center or hospital outpatient department. The clinical workflow includes preoperative consent, anesthesia evaluation, operative excision with possible microsurgical dissection, specimen submission (TC/26 considerations for technical/professional components), postoperative recovery in PACU, and follow-up for wound check and pathology review. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthCare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |