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The CPT® Code 23150 refers to the excision or curettage of a bone cyst or benign tumor located in the proximal humerus. A bone cyst is defined as a fluid-filled space within the bone, which can vary in type and presentation. One of the most common forms is the unicameral or simple bone cyst, recognized as a benign lesion that typically does not pose significant health risks. Another type, the aneurysmal bone cyst, is characterized by vascular tissue surrounding a blood-filled cystic lesion, which may require more careful management due to its nature. Additionally, benign bone tumors encompass a variety of conditions, including giant cell tumors, chondromyxoid fibromas, and enchondromas, all of which can occur in the proximal humerus. In the procedure described by CPT® Code 23150, a surgical incision is made over the lesion site on the proximal humerus, allowing for the dissection of soft tissues to expose the lesion. If a cystic lesion is identified, the surgeon incises the bone to create a window, facilitating access to the cyst. The fluid within the cyst is then aspirated and sent for laboratory analysis, which is reportable separately. Following this, a curette is utilized to remove the lining of the cystic cavity completely. In cases where benign tumors are present, the procedure may involve excising the tumor along with a margin of healthy bone to ensure complete removal. This detailed approach is essential for effective treatment and management of bone cysts and benign tumors in the proximal humerus.
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The procedure described by CPT® Code 23150 is indicated for the treatment of various conditions affecting the proximal humerus, specifically:
The procedure involves several critical steps to ensure effective treatment of the bone cyst or benign tumor:
Post-procedure care following the excision or curettage of a bone cyst or benign tumor in the proximal humerus typically involves monitoring for complications such as infection or excessive bleeding. Patients may be advised to limit movement of the affected arm to promote healing and prevent strain on the surgical site. Follow-up appointments are essential to assess recovery and ensure that the site is healing properly. Additionally, any fluid sent for laboratory analysis will be reviewed to determine if further treatment is necessary based on the findings.
| Short Descr | REMOVAL OF HUMERUS LESION | Medium Descr | EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS | Long Descr | Excision or curettage of bone cyst or benign tumor of proximal humerus; | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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