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Official Description

Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25077 refers to the radical resection of a tumor located in the soft tissue of the forearm and/or wrist area, specifically when the tumor measures less than 3 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 classified as either benign or malignant. However, radical resection is primarily indicated for malignant neoplasms, such as sarcomas, although it may also be necessary for benign tumors or those of uncertain nature. The procedure begins with the creation of a skin incision directly over the tumor site in the forearm or wrist, or alternatively, a skin flap may be elevated to access the tumor. The surgeon meticulously dissects the overlying tissue to expose the tumor, which is then excised en bloc, meaning it is removed in one piece along with a wide margin of healthy surrounding tissue. This approach ensures that all involved soft tissue is excised, which may include critical structures such as muscles, nerves, and blood vessels. To confirm that the surgical margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain malignancy, additional tissue will be excised until clear margins are achieved. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound can be closed in layers. In some cases, additional reconstructive procedures may be required and reported separately. For coding purposes, CPT® Code 25077 is specifically designated for the radical resection of soft tissue tumors in the forearm and wrist that are less than 3 cm in size, while CPT® Code 25078 is used for tumors measuring 3 cm or greater.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The radical resection of soft tissue tumors in the forearm and wrist area, as described by CPT® Code 25077, is indicated for the following conditions:

  • Malignant Neoplasms Tumors that are cancerous, such as sarcomas, which require complete removal to prevent further spread.
  • Benign Tumors Non-cancerous tumors that may still necessitate radical resection due to size, location, or symptoms they may cause.
  • Indeterminate Tumors Tumors of uncertain nature that require further evaluation and potential removal to determine their characteristics and appropriate treatment.

2. Procedure

The procedure for radical resection of a soft tissue tumor in the forearm and/or wrist area involves several critical steps:

  • Step 1: Incision A skin incision is made directly over the tumor site in the forearm and/or wrist area. In some cases, a skin flap may be created and elevated to provide better access to the tumor.
  • Step 2: Dissection The surgeon carefully dissects the overlying tissue to expose the tumor. This step is crucial to ensure that the tumor is adequately visualized and that surrounding structures are preserved as much as possible.
  • Step 3: Tumor Removal The tumor is excised en bloc, meaning it is removed in one piece along with a wide margin of healthy surrounding tissue. This approach is essential to ensure that all cancerous cells are removed and to minimize the risk of recurrence.
  • Step 4: Frozen Section Analysis A separately reportable frozen section may be performed during the procedure to assess the surgical margins for the presence of tumor cells. This step is critical for determining whether additional tissue needs to be removed.
  • Step 5: Additional Tissue Removal If the frozen section analysis indicates that the margins are not free of tumor cells, additional tissue will be excised until clear margins are achieved.
  • Step 6: Drain Placement Drains may be placed as needed to manage any fluid accumulation that may occur post-operatively.
  • Step 7: Wound Closure The surgical wound may be closed in layers, ensuring proper healing, or separately reportable reconstructive procedures may be performed if necessary.

3. Post-Procedure

After the radical resection procedure, patients can expect a recovery period that may vary based on the extent of the surgery and individual health factors. Post-operative care typically includes monitoring for signs of infection, managing pain, and ensuring proper wound healing. Patients may be advised on activity restrictions to promote healing and prevent complications. Follow-up appointments will be necessary to assess recovery and to discuss any further treatment options, especially if the tumor was malignant. Additionally, the placement of drains may require care to ensure they function properly and are removed at the appropriate time. The surgical team will provide specific instructions tailored to the patient's needs to facilitate a smooth recovery process.

Short Descr RESECT FOREARM/WRIST TUM<3CM
Medium Descr RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
Long Descr Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 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) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
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 Non office-based surgical procedure added in CY 2008 or later; 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 160 - Other therapeutic procedures on muscles and tendons
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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
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2014-01-01 Changed Description Changed
2013-01-01 Changed Medium Descriptor changed.
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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