Summary & Overview
CPT 26250: Radical Resection of Metacarpal Bone Tumor
CPT code 26250 denotes radical resection of a metacarpal bone tumor, a surgical procedure used to remove rapidly growing benign or malignant tumors of the metacarpal and surrounding healthy tissue. The code applies to cases of recurrent, aggressive, or metastatic disease that require extensive excision. Nationally, this code is significant for hospital surgical oncology and orthopedic billing, given the resource intensity, potential inpatient care, and multidisciplinary management these cases demand.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about when the procedure is used, typical sites of service, and the implications for coding and hospital billing workflows. The publication also summarizes common modifier usage and highlights areas where additional documentation and operative detail are typically required for accurate billing.
This report provides benchmarks for utilization and common billing practices, outlines policy considerations relevant to payer coverage and prior authorization, and situates the procedure within surgical oncology and orthopedic service lines. Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Billing Code Overview
CPT code 26250 describes a radical resection of a metacarpal bone tumor, in which the provider removes a rapidly growing benign or malignant tumor of the metacarpal along with surrounding healthy tissue. The procedure is performed for recurrent, aggressive, or metastatic tumors that require extensive surgical resection.
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Service type: Surgical oncology / orthopedic tumor resection
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Typical site of service: Hospital operating room or ambulatory surgical center for inpatient or same-day surgical care, depending on extent of resection and patient needs.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents with a rapidly enlarging mass centered over the shaft of the second metacarpal of the dominant hand. Imaging with radiographs and MRI demonstrates a lytic lesion with cortical destruction and soft-tissue extension suspicious for an aggressive benign tumor (e.g., giant cell tumor) or primary/metastatic malignancy. The patient has progressive pain, reduced range of motion, and concern for local structural compromise. Following multidisciplinary evaluation and biopsy confirming tumor type and margins concerns, the hand surgeon schedules a radical resection of the involved metacarpal.
Preoperative workflow includes history and physical, review of imaging, staging as indicated, informed consent discussing potential reconstruction or amputation, anesthesia evaluation, and baseline neurovascular documentation. Intraoperative steps include tumor resection with surrounding healthy tissue, margin assessment, possible intraoperative frozen section, reconstruction (bone graft, fixation, or prosthetic/vascularized flap) as required, and placement of drains. Postoperative workflow includes pathology review of final margins, wound care, pain control, hand therapy planning, and oncologic follow-up for adjunctive therapy when indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right hand metacarpal |