CPT 24071Surgery

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CPT 24071 covers the surgical removal of a soft tissue lesion (growth or lump) from the arm or elbow area when the lesion is 3 centimeters or larger and located in the subcutaneous tissue (beneath the skin but above the muscle).

Showing rates for

National Average

Base Medicare rate

$402.07

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

5.7

PE RVU (NF)

5.44

MP RVU

1.29

Total RVU

12.43

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document exact lesion measurement in three dimensions (length x width x depth) in operative report, with explicit confirmation that greatest dimension exceeds 3cm
Impact: Prevents downcoding to 24066 (lesions <3cm) which reimburses $107 less; measurement documentation is the #1 audit focus
Clearly specify subcutaneous location in operative note and distinguish from subfascial/intramuscular lesions which require different codes (24073-24079)
Impact: Incorrect depth coding can result in denial or reimbursement variance of $200-600 depending on actual code required
When multiple lesions are excised, bill each separately with modifier 51 on secondary procedures, ensuring each meets size and location criteria for 24071
Impact: Maximizes reimbursement at $402.07 for first lesion plus approximately $201.04 per additional qualifying lesion
For complex excisions requiring skin grafts or flaps, bill closure code separately (14000-14300 series) as these are not bundled with excision
Impact: Can add $300-1,200 in reimbursement for intermediate or complex repairs not included in excision payment
Always include pathology report with final diagnosis to support medical necessity; pre-authorization often required for lesions without prior biopsy confirmation
Impact: Reduces denial rate by 40-60% and expedites payment processing; lack of pathology correlation is common audit trigger
Bill facility and non-facility settings correctly; both reimburse identically at $402.07 for 24071, but proper place of service code is essential for claim accuracy
Incorrect POS coding can delay payment 30-45 days or trigger manual review even though rate is identical

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 24071 in 2025?

The 2025 Medicare national average reimbursement for CPT 24071 is $402.07 for both facility and non-facility settings. This rate is based on 12.43 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How do I know whether to use CPT 24071 or 24066 for arm lesion excision?

Use CPT 24071 when the lesion measures 3 centimeters or greater in its largest dimension. Use CPT 24066 for lesions smaller than 3cm. The measurement should be taken in-vivo before excision and documented in the operative report, as pathology specimen measurements may be smaller due to tissue shrinkage.

Can I bill CPT 24071 multiple times for multiple lesions during the same surgery?

Yes, you can bill 24071 for each separate lesion that meets the size and location criteria. The first lesion is billed without modifiers (except laterality), and subsequent lesions require modifier 51, which typically reduces reimbursement for secondary procedures to approximately 50% of the primary procedure rate.

What is the difference between CPT 24071 and 24073 for arm tumor excision?

CPT 24071 is for subcutaneous lesions (below the skin but above the muscle fascia) 3cm or larger, while CPT 24073 is for subfascial or intramuscular tumors 3cm or larger. The key distinction is tissue depth: subcutaneous lesions do not penetrate the deep fascia, while subfascial/intramuscular lesions involve deeper tissue planes.

Do I need preauthorization for CPT 24071?

Preauthorization requirements vary by payer. Medicare typically does not require prior authorization for 24071, but many commercial payers and Medicare Advantage plans do require it, especially for lesions without prior biopsy confirmation or when malignancy has not been documented. Always verify specific payer requirements before scheduling.

How should I document lesion size to prevent denials for CPT 24071?

Document the lesion's three-dimensional measurements (length x width x depth) in the operative report with specific numbers, not approximations. Clearly state the greatest dimension and confirm it meets or exceeds 3cm. Include measurement method (ruler, calipers) and timing (pre-excision in-vivo measurement). Correlation with pathology specimen dimensions strengthens documentation.

What RVU value does CPT 24071 carry for 2025?

CPT 24071 has a total RVU of 12.43 for 2025, consisting of 5.7 work RVUs, 5.44 practice expense RVUs (both facility and non-facility), and 1.29 malpractice RVUs. This RVU value reflects the moderate complexity and time required for subcutaneous lesion excisions 3cm or larger.