CPT® Code 21016

Radical resection of a tumor, specifically for soft tissue of the face or scalp, is a surgical procedure primarily indicated for the removal of malignant neoplasms, such as sarcomas. However, it is important to note that benign tumors and tumors of indeterminate nature may also necessitate this extensive surgical intervention. The procedure is characterized by the excision of the tumor along with a significant margin of surrounding healthy tissue to ensure complete removal of cancerous cells. This is crucial for preventing recurrence and ensuring the best possible outcome for the patient. The surgical approach may vary based on the tumor's location; it may involve incising the skin directly over the tumor, creating and elevating a skin flap, or making incisions along natural skin creases to facilitate optimal exposure of the tumor. During the procedure, the surgeon meticulously dissects the soft tissue surrounding the tumor to fully expose it, allowing for the radical resection of all involved tissues, which may include muscles, nerves, and blood vessels. The goal is to achieve clear margins, which is confirmed through a separately reportable frozen section examination. If any malignancy is detected at the margins, further tissue removal is performed until all margins are confirmed to be free of tumor cells. Following the resection, the surgeon repairs the affected muscle and soft tissues, and may also perform a reconstructive procedure using various grafts or flaps, either during the same surgical session or at a later date. Additionally, drains may be placed as necessary, and the overlying skin is closed in layers to promote healing.