Radical resection of a soft-tissue tumor of the forearm and/or wrist measuring less than 3 cm, typically performed for sarcoma or other aggressive neoplasms requiring wide-margin excision.

Verified May 8, 2026 · 6 sources ↓

Medicare: $830.68
Total RVUs: 24.87
Global, days: 90
Region: Wrist

Drawn from CMSEmednyAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Operative note must state radical resection with wide surgical margins — generic language like 'tumor removed' is insufficient for 25077
Tumor size measured in the specimen or on imaging must be documented as less than 3 cm to support this code over 25078
Pathology report documenting specimen submission is required; radical resection implies histologic analysis to confirm margins and tumor type
Anatomic location must specify forearm and/or wrist; proximal arm or hand lesions belong to different code families
Indication must support aggressive/malignant etiology (e.g., sarcoma); benign deep mass excision codes to 25076, not 25077
If bilateral or laterality-specific, document which extremity (left, right) to support LT/RT modifiers

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

25077 covers radical resection — not simple excision — of a soft-tissue tumor in the forearm or wrist when the specimen is less than 3 cm. The distinction from 25076 (deep subfascial excision) is intent and margin: radical resection requires removal of the tumor with a surrounding cuff of normal tissue, the standard oncologic approach for sarcomas. The pathology specimen goes to the lab; the operative note must reflect wide-margin technique, not just removal of a deep mass.

Code selection within the forearm/wrist tumor family turns on two variables: depth and procedure type. 25075 is subcutaneous excision under 3 cm; 25076 is deep/subfascial excision under 3 cm; 25077 is radical resection under 3 cm; 25078 is radical resection 3 cm or greater. Using 25076 when radical resection with oncologic margins was performed is an under-coding error — and using 25077 for a routine deep excision of a lipoma or ganglion is an over-coding error. The operative report language must match the code.

The 90-day global period means all routine follow-up through day 90 is bundled. Oncology follow-up for wound surveillance is included. If a separately identifiable E/M is needed at a post-op visit for a reason unrelated to the tumor resection — say, a new injury or unrelated complaint — bill with modifier 24. If the patient returns to the OR during the global for a related complication (e.g., wound dehiscence), use modifier 78. An unrelated procedure in the global window gets modifier 79.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	12.61
Practice expense RVU	8.9
Malpractice RVU	3.36
Total RVU	24.87
Medicare national rate	$830.68
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	$830.68
HOPD (APC 5073) Hospital outpatient department	$2,967.63
ASC (PI G2) Ambulatory surgical center (freestanding)	$1,248.36

Common denial reasons

The recurring reasons claims for CPT 25077 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Code 25076 billed instead of 25077 — or vice versa — when documentation doesn't clearly distinguish deep excision from radical resection with oncologic margins
Tumor size not documented or ambiguous: missing a sub-3 cm measurement sends the claim to 25078 territory or triggers a medical records request
Diagnosis code mismatch: benign soft-tissue ICD-10 codes (e.g., M79.x lipoma family) paired with a radical resection code raise medical necessity flags
Procedure billed during the global period of a related prior surgery without modifier 78 or 79, causing automatic denial
Missing or incomplete pathology report when payer requires it to validate radical resection intent

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What separates 25077 from 25076?

25076 is a deep subfascial excision of a forearm/wrist tumor under 3 cm. 25077 is a radical resection — wide-margin removal with a cuff of normal tissue — typically for sarcoma. The procedure intent and margin technique, not just the depth, determine which code applies. Document explicitly that wide margins were obtained.

02When does tumor size push the code to 25078?

When the radical resection specimen measures 3 cm or greater, bill 25078. Use the pathology report or intraoperative measurement to confirm size. If imaging measured 2.8 cm but the resected specimen with margins comes in at 3.1 cm, the specimen size controls.

03Can 25077 and 25076 both be billed if two separate tumors are resected in the same session?

Yes, if two anatomically distinct tumors were treated — one with radical resection, one with deep excision — bill both with modifier 59 or XS on the secondary code to indicate a separate structure. Document each lesion separately in the operative report with distinct size, location, and technique.

04What modifier applies if the patient returns to the OR during the 90-day global for wound complications?

Use modifier 78 for an unplanned return to the OR for a complication related to the original resection — for example, wound dehiscence or hematoma evacuation. Modifier 79 is for an unrelated procedure by the same surgeon during the global period. Don't invert these.

05Is 25077 appropriate for a large benign lipoma in the forearm?

No. Radical resection implies oncologic margins for aggressive or malignant tumors. A benign lipoma, ganglion, or similar mass removed via deep excision codes to 25076. Using 25077 for benign lesions is an over-coding error and a medical necessity denial risk when the ICD-10 doesn't support malignancy.

06Does the site of service affect payment for 25077?

Yes. HOPD and ASC reimbursement differ — see the Site of Service comparison table on this page. The physician's professional fee is also subject to the site-of-service differential under the CMS Physician Fee Schedule 2026, with a lower non-facility rate applicable when performed in an office setting.

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 surgical approach, margin intent (radical vs. simple excision), measured tumor dimensions, anatomic depth (subfascial vs. subcutaneous), laterality, and specimen disposition from the dictated operative note. That prevents the most common 25077 audit trigger: an operative report that reads like a routine deep excision when radical oncologic resection was actually performed — a documentation gap that collapses reimbursement to 25076 on review.

See how Mira captures CPT 25077 documentation