CPT® Code 26118

Radical resection of a tumor in the soft tissue of the hand or finger, designated by CPT® Code 26118, involves the surgical removal of a tumor that measures 3 cm or greater. The term "soft tissue" encompasses various structures, including muscles, tendons, fat, blood vessels, lymph vessels, nerves, and the tissues surrounding joints. This procedure is primarily indicated for malignant neoplasms, such as sarcomas, but may also be necessary for benign tumors or those of indeterminate nature. The surgical approach typically begins with a skin incision made directly over the tumor or the creation of a skin flap that is elevated to access the underlying tissue. During the procedure, 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 surrounding healthy tissue. This wide margin is critical to ensure that all cancerous cells are removed, thereby reducing the risk of recurrence. The radical resection may involve the excision of not only the tumor but also any affected soft tissues, which can include 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 malignancy is detected at the margins, 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 or may require additional reconstructive procedures, which are reported separately. It is important to note that CPT® Code 26117 is used for the radical resection of soft tissue tumors of the hand or finger that are less than 3 cm in size.