Summary & Overview
CPT 25078: Excision of Forearm/Wrist Soft Tissue Tumor with Wide Excision
CPT code 25078 denotes surgical excision of a soft tissue tumor in the forearm and/or wrist with wide local excision of 3 cm or more of surrounding tissue. This code captures higher-complexity oncologic resections of distal upper-extremity soft tissue masses and is important for accurate clinical documentation, procedural classification, and national payment and quality measurement frameworks. Proper use of the code ensures the procedure’s clinical scope is clear for reimbursement and downstream care coordination.
Key payers considered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect benchmarking context for coverage and usual site-of-service settings, a clinical summary of indications and procedural scope, and notes on documentation elements relevant to payer adjudication. The summary highlights how the code differentiates from less-extensive excisions and why margin size and anatomic location affect coding and billing classification.
This publication covers clinical context, common modifiers and billing considerations (listed separately), typical service lines and sites of care, and what to check in operative documentation to support use of CPT code 25078. Data not available in the input is indicated where applicable.
Billing Code Overview
CPT code 25078 describes a surgical procedure in which a provider removes a soft tissue tumor from the forearm and/or wrist area along with an extensive margin of surrounding tissue measuring 3 centimeters or more. This procedure is performed to achieve adequate oncologic margins for tumors of the distal upper extremity.
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Service type: Surgical excision of soft tissue tumor with wide local excision
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Typical site of service: Hospital outpatient department or ambulatory surgical center; may also occur in an inpatient surgical setting depending on clinical complexity and perioperative needs
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents with a progressively enlarging, firm soft tissue mass on the volar forearm measuring 4.0 cm on clinical exam and confirmed by ultrasound/MRI to be confined to soft tissue without neurovascular invasion. The mass is symptomatic with pain and limited wrist/forearm motion. After preoperative evaluation and informed consent, the patient is scheduled for a surgical excision of the tumor with wide local resection of surrounding tissue (3 cm or more) to achieve clear margins. The procedure is performed in an ambulatory surgical center or hospital operating room under regional or general anesthesia. Intraoperative frozen section or permanent pathology is used to confirm margins. Postoperative workflow includes wound care instructions, pathology result review, and coordination of further oncologic care or rehabilitation if needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left forearm/wrist |
RT | Right side | When the procedure is performed on the right forearm/wrist |