Surgical excision of a subcutaneous soft tissue tumor of the upper arm or elbow area measuring less than 3 cm.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $569.49
- Total RVUs
- 17.05
- Global, days
- 90
- Region
- Elbow
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Measured lesion size in centimeters (tumor, not excision margin) confirmed under 3 cm
- Explicit documentation that the tumor is subcutaneous — above the deep fascia
- Anatomic location specified as upper arm or elbow area, with laterality (left or right)
- Operative note names the approach and confirms complete excision with description of wound closure
- Pathology specimen submitted and report cross-referenced to the operative note
- Preoperative diagnosis and indication for excision documented in the chart
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 5 cited references ↓
24075 covers removal of a subcutaneous soft tissue tumor in the upper arm or elbow region when the lesion measures under 3 cm. The subcutaneous designation is critical: the tumor must lie above the deep fascia. If the lesion is intramuscular or subfascial, step up to 24071 (subcutaneous, 3 cm or greater) or 24073 (deep, 5 cm or greater). Size is measured as the tumor itself, not the excision margin — document both in the operative note.
The 90-day global period covers the operative day, the day-before visit, and all routine follow-up through day 90. Any unrelated E/M visit during that window requires modifier 24. A separate significant and separately identifiable E/M on the day of surgery needs modifier 25. Pathology is separately reportable and not bundled into the global.
Dermatology bills this code frequently, but orthopedic and general surgeons encounter it when removing lipomas, ganglia, or other benign soft tissue masses around the elbow. If you're billing 24075 alongside another upper extremity procedure through a different incision on the same day, modifier 59 or XS documents the distinct anatomic site and bypasses NCCI bundling edits.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 4.13 |
| Practice expense RVU | 12.02 |
| Malpractice RVU | 0.9 |
| Total RVU | 17.05 |
| Medicare national rate | $569.49 |
| Global period | 90 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $569.49 |
HOPD (APC 5072) Hospital outpatient department | $1,687.37 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $742.04 |
Common denial reasons
The recurring reasons claims for CPT 24075 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Size not documented in the operative note, preventing payer verification of the less-than-3-cm threshold
- Upcoded to 24071 or 24073 without documentation supporting depth (subfascial) or larger size
- Bundled denial when billed same-day with another upper extremity procedure without modifier 59 or XS
- Missing laterality — payer cannot confirm LT or RT without it, triggering administrative denial
- E/M billed same-day without modifier 25, resulting in global-period bundling denial
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01What is the size cutoff that separates 24075 from 24071?
02When does a soft tissue tumor at the elbow cross into deep-tumor territory?
03Can 24075 and an E/M be billed on the same day?
04How do you handle billing 24075 when a second unrelated procedure is performed on the same arm during the same session?
05Does the 90-day global period include pathology interpretation?
06Should laterality modifiers LT and RT be used routinely with 24075?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira AI Scribe
Mira's AI scribe captures the measured lesion size, tissue depth (subcutaneous vs. deep to fascia), anatomic location, laterality, and wound closure technique directly from dictation. That prevents the most common audit flag for 24075: an operative note that states 'lesion excised' without documenting the sub-3-cm measurement or confirming subcutaneous depth — both required to defend the code against upcoding scrutiny or a size-threshold denial.
See how Mira captures CPT 24075 documentation