Summary & Overview
CPT 26118: Extensive Hand/Finger Soft Tissue Tumor Excision ≥3 cm
CPT code 26118 covers extensive surgical excision of a soft tissue tumor in the hand or finger when the lesion and surrounding tissue measure 3 cm or more. This code is used for larger or more complex tumor resections that often require detailed dissection, potential reconstruction, and care in a sterile operative setting. Nationally, accurate use of this code affects provider billing, claims adjudication, and quality measurement for hand surgery procedures.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers commonly influence coding guidance, medical necessity review, prior authorization practices, and reimbursement policies for hand surgery services.
Readers will find a concise briefing on clinical context and service setting for 26118, typical sites of care, and which payers are relevant to coverage discussions. The publication provides benchmark and policy-oriented content where available, highlights common modifiers and administrative considerations provided in the input, and summarizes practical coding relationships. Data not available in the input will be noted as such in specific analytic sections. The goal is to give clinicians, coding staff, and policy stakeholders a clear national overview of what CPT code 26118 represents and where it fits in surgical hand care coding.
Billing Code Overview
CPT code 26118 describes extensive surgical removal of a soft tissue tumor and surrounding tissues of the hand or finger measuring 3 cm or more. This procedure involves excision of a large soft tissue mass in the digits or hand where wider margins and more complex dissection are typically required compared with smaller tumor removals.
Service type: Surgical — hand/finger soft tissue tumor excision (extensive)
Typical site of service: Hospital outpatient surgical suite or ambulatory surgery center (hand surgery setting)
Clinical & Coding Specifications
Clinical Context
A 54-year-old right-hand-dominant patient presents to a hand surgery clinic with a progressively enlarging, painless soft-tissue mass on the dorsal aspect of the long finger. On exam the lesion measures approximately 3.5 cm, is mobile relative to underlying bone but appears adherent to subcutaneous tissues, and causes intermittent catching with extension. Ultrasound and MRI characterize a well-circumscribed soft-tissue tumor suspected to be a benign neoplasm (e.g., giant cell tumor of tendon sheath or deep-seated lipoma) but large enough to require wide excision. The clinical workflow includes preoperative evaluation, informed consent for tumor excision of the hand/finger, pre-op anesthesia assessment (local/regional block or general anesthesia), intraoperative surgical excision of the tumor with adequate margins and possible reconstruction of soft tissue (local flap or skin graft if needed), specimen submission to pathology, postoperative pain control, wound care instructions, and short-term follow-up for wound check and pathology review. Typical site of service is an ambulatory surgical center or hospital outpatient department; anesthesia may be monitored anesthesia care or general anesthesia depending on complexity. Billing uses 26118 for excision of a soft tissue tumor of the hand or finger measuring 3 cm or greater; documentation should include tumor size, location, extent of surrounding tissue excision, anesthesia type, and pathology specimen handling.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |