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The CPT® Code 23077 refers to the radical resection of a tumor located in the soft tissue of the shoulder area, specifically when the tumor measures less than 5 cm. Soft tissues encompass a variety of structures, including muscles, tendons, fat, blood vessels, lymph vessels, nerves, and the tissues that surround joints. Tumors that arise in these soft tissues can be either benign or malignant. A radical resection is a surgical procedure that aims to remove a tumor along with a significant margin of surrounding healthy tissue to ensure complete excision, particularly in cases of malignant neoplasms such as sarcomas. However, it is important to note that benign tumors or those of uncertain nature may also necessitate a radical resection. The procedure typically begins with a skin incision made directly over the tumor or the creation of a skin flap that is elevated to access the underlying tissue. The surgeon then meticulously dissects the overlying tissue to expose the tumor, which is removed en bloc, meaning the tumor and a wide margin of surrounding tissue are excised together. This comprehensive approach is crucial as it involves the removal of all affected soft tissue, which may include critical structures such as muscles, nerves, and blood vessels. To ensure that the surgical margins are free of tumor cells, a frozen section analysis may be performed during the procedure. If any malignancy is detected at the margins, additional tissue will be excised until clear margins are achieved. Post-surgery, drains may be placed as necessary to prevent fluid accumulation, and the surgical wound can be closed in layers or may require separate reconstructive procedures, depending on the extent of the resection. For tumors measuring 5 cm or greater, the appropriate code to use is 23078.
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The radical resection of a tumor in the soft tissue of the shoulder area, as described by CPT® Code 23077, is indicated for the following conditions:
The procedure for radical resection of a tumor in the shoulder area involves several critical steps:
Post-procedure care following a radical resection of a tumor in the shoulder area includes monitoring for complications, managing pain, and ensuring proper wound healing. Patients may require follow-up visits to assess the surgical site and to evaluate for any signs of recurrence or complications. The placement of drains, if utilized, will be monitored and removed as appropriate. Recovery may vary depending on the extent of the resection and the individual patient's health status. Rehabilitation may also be necessary to restore function and mobility in the shoulder area following the surgery.
| Short Descr | RESECT SHOULDER TUMOR < 5 CM | Medium Descr | RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM | Long Descr | Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2014-01-01 | Changed | Description Changed |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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