Summary & Overview
CPT 26113: Excision of Subfascial Hand or Finger Tumor ≥1.5 cm
CPT code 26113 covers surgical excision of a subfascial tumor or vascular malformation from the soft tissue of the hand or finger when the specimen or resection is 1.5 cm or greater. Nationally, this code captures a specific set of hand surgery procedures that have implications for surgical coding accuracy, appropriate payment for deep soft tissue resections, and clinical documentation of lesion depth and size. Key payers in the scope of typical coverage include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find guidance on the clinical context in which the code is applied, the typical sites of service where these procedures occur, and the documentation elements that support proper use of the code. The publication provides benchmarks and policy-oriented context relevant to claims adjudication and payer coverage considerations, as well as comparisons to related soft-tissue excision codes where available. Content is intended to help coding professionals, surgical practices, and billing teams understand when 26113 is the appropriate code and what aspects of the procedure and record commonly influence payer review and payment decisions. Data not available in the input for certain comparative metrics or payer-specific reimbursement rates is noted where applicable.
Billing Code Overview
CPT code 26113 describes the excision of a subfascial tumor or vascular malformation from the soft tissue of the hand or finger when the resection size is 1.5 cm or more. This procedure involves surgical removal of a deep-seated lesion beneath the fascial layer of the hand or finger soft tissues.
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Service type: Surgical excision of soft tissue mass (deep/subfascial)
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Typical site of service: Operative setting for hand or finger surgery (hospital outpatient department, ambulatory surgery center, or surgeon's operating room)
Clinical & Coding Specifications
Clinical Context
A 52-year-old right-hand dominant patient presents to the outpatient hand surgery clinic with a progressively enlarging, painful subfascial mass over the volar aspect of the middle finger that limits flexion and causes paresthesia. Physical exam demonstrates a firm, well-circumscribed, deep soft-tissue mass adherent to underlying structures. Preoperative imaging (ultrasound or MRI) confirms a 1.8 cm vascular malformation / soft-tissue tumor confined to the subfascial plane of the finger without bone invasion. The clinical workflow includes preoperative evaluation and informed consent, preoperative localization and marking, regional or local anesthesia (possible monitored anesthesia care), surgical excision of the subfascial tumor or vascular malformation with careful dissection to preserve neurovascular bundles and tendon sheath, hemostasis, layered closure, and application of a sterile dressing and postoperative splint. Pathologic specimen is sent for histopathology. Typical post-anesthesia recovery occurs in an ambulatory surgery center or hospital outpatient department with postoperative instructions, wound care, follow-up visit for wound check and suture removal, and referral to hand therapy if motion is limited.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | When the same excision is performed on both hands or corresponding fingers in the same operative session. |