Summary & Overview
CPT 64788: Excision of Subcutaneous Tumor Along Cutaneous Nerve
CPT code 64788 denotes the surgical excision of a tumor located just under the skin that is growing along a cutaneous nerve. Nationally, this code captures procedures that address subcutaneous neoplasms with direct nerve involvement—cases that can involve delicate dissection to remove the lesion while preserving nerve function where possible. The code matters for surgical specialties, outpatient surgical centers, and insurers because it reflects a targeted procedure with implications for operative setting, anesthesia, and post‑operative management.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the procedural focus of the code. The publication summarizes benchmarking elements and coverage considerations at a national level, highlights common billing modifiers associated with surgical services (listed separately), and outlines what clinicians and billing teams need to know about coding specificity for nerve‑associated subcutaneous tumor excision. If specific payer policies or national reimbursement benchmarks are available, those elements are presented in dedicated sections; if not, the report notes data limitations. This resource is intended to orient clinicians, coding staff, and policy analysts to the clinical and billing identity of CPT code 64788.
Billing Code Overview
CPT code 64788 describes the surgical excision of a tumor located beneath the skin that is growing along a cutaneous nerve. This procedure involves removal of a subcutaneous neoplasm with direct involvement of a superficial sensory nerve.
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Service type: Surgical excision of a cutaneous nerve–associated subcutaneous tumor
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Typical site of service: Outpatient surgical suite, ambulatory surgery center, or hospital operating room depending on complexity and anesthesia needs
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to the outpatient dermatologic surgery clinic with a small, painful, slow-growing subcutaneous mass along the course of the superficial radial sensory nerve on the dorsal forearm. The lesion is tender to palpation and produces paresthesia in the radial nerve distribution. The provider performs a focused history and physical, documents neurologic symptoms, obtains informed consent, and schedules the patient for an excisional procedure under local anesthesia with monitored anesthesia care as needed.
In the procedure suite, sterile preparation and local anesthetic infiltration are performed. A small incision is made directly over the palpable mass, careful dissection is carried down through subcutaneous tissue to identify the tumor arising from a cutaneous nerve. The lesion is excised with preservation of surrounding nerve fascicles when possible. Hemostasis is achieved, the wound is irrigated, and layered closure is performed. The specimen is sent for histopathology. Typical post-procedure workflow includes recovery monitoring, wound care instructions, pathology follow-up, and documentation of complications or changes in neurologic status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Data not available in the input. |