Summary & Overview
CPT 26115: Excision of Subcutaneous Tumor or Vascular Malformation, Hand/Finger
CPT code 26115 identifies a small soft-tissue surgical procedure: excision of a subcutaneous tumor or vascular malformation from the hand or finger with a resection size under 1.5 cm. This narrowly defined code is used to report minor excisions on digits and the hand and is relevant across surgical, orthopedic, and hand-specialty practices. Accurate use affects national billing consistency and downstream payment and quality measurement for ambulatory soft-tissue procedures. Key payers in this national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical and billing scope of the code, common places of service, and the typical procedural context for hand and finger mass removal. The publication also provides benchmarking context, common modifier usage (listed separately), and policy or coverage considerations that influence claim adjudication. Clinical context covers indications for excision of small subcutaneous tumors and vascular malformations in the hand or finger and procedural expectations. This overview is intended to inform coding accuracy, claim documentation, and payer discussions at a national level. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 26115 describes the excision of a subcutaneous tumor or vascular malformation from the soft tissue of the hand or finger when the resection size is under 1.5 cm. The procedure involves removal of a small, localized soft-tissue mass beneath the skin of a digit or the hand.
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Service type: Minor soft-tissue excision / outpatient surgical procedure
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Typical site of service: Ambulatory surgery center, hospital outpatient department, or physician office procedure room
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient hand surgery clinic with a small, palpable subcutaneous mass on a finger or the palmar/ dorsal hand that is symptomatic (painful, tender, or limits function) or cosmetically concerning. Examination reveals a well-circumscribed, noninfiltrative lesion under 1.5 cm consistent with a ganglion, lipoma, glomus tumor, or small vascular malformation. Imaging (plain radiographs and/or ultrasound) may be performed preoperatively to confirm size, depth, and relation to tendons or neurovascular structures. The patient is consented for excision under local anesthesia with or without sedation in an ambulatory surgical center or office procedure room. The provider prepares the field, administers local anesthetic, makes a small incision, dissects to the subcutaneous mass, achieves hemostasis, and closes the wound with sutures. Specimen is sent for pathology when indicated. Postoperative instructions include wound care, activity restrictions, and a follow-up visit for suture removal and assessment of function and healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and complexity substantially exceed typical for 26115 (document specifics). |