Surgical removal of a subfascial (e.g., intramuscular) soft-tissue tumor in the hip or pelvis area, with the tumor measuring less than 5 cm in greatest dimension.

Verified May 8, 2026 · 7 sources ↓

Medicare: $586.85
Total RVUs: 17.57
Global, days: 90
Region: Hip

Drawn from CMSAAPCFindacodeMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Tumor size in centimeters — measured specimen, not estimated — documented in the operative report
Explicit confirmation of subfascial (intramuscular or deeper) depth, not subcutaneous
Anatomic location within the hip or pelvis area stated by name, not just 'hip mass'
Pathology report or specimen submission to confirm tissue type and correlate with ICD-10 diagnosis
Surgical approach described in detail — incision location, dissection planes, layer-by-layer closure
Pre-operative imaging (MRI or CT) referenced in the note to support depth and size characterization

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 80 Assistant surgeon 62 Co-surgeons

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27048 covers excision of a deep soft-tissue tumor of the hip or pelvis — subfascial, meaning below the fascia and typically intramuscular — where the lesion measures under 5 cm. The depth distinguishes this code from its superficial counterparts (27043–27045); if the tumor is subcutaneous rather than subfascial, those codes apply instead. Size and depth must both be documented in the operative note to justify 27048 over the larger-lesion code 27049 (5 cm or greater).

The 90-day global period means all routine post-op visits, wound checks, and stitch removals through day 90 are bundled. Separate E&M services during that window require modifier 24 (unrelated) or 25 (significant, separately identifiable, same-day pre-op). A new or worsening problem unrelated to the tumor excision billed during the global needs modifier 24 with clear documentation tying the visit to a distinct diagnosis.

Site of service matters here: the HOPD and ASC payment rates differ substantially. If you're performing this in a facility setting, the surgeon collects the professional component only — the facility bills separately. Confirm your operative report captures both the subfascial depth and the measured specimen size before submitting; missing either triggers downcoding or denial.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.63
Practice expense RVU	6.93
Malpractice RVU	2.01
Total RVU	17.57
Medicare national rate	$586.85
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	$586.85
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 27048 get rejected.

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

Size not documented: missing measured specimen dimensions causes downcoding or outright denial
Depth insufficiently established — 'deep excision' without explicit subfascial language triggers review
ICD-10 diagnosis mismatch: benign vs. malignant neoplasm codes must align with pathology and clinical intent
Billing 27048 and 27049 together without modifier 59 when two distinct lesions were excised same session
Unbundling routine closure — layered repair is included in the global surgical package and cannot be separately reported

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What separates 27048 from 27047 and 27049?

27047 covers superficial (subcutaneous) tumors under 3 cm; 27043 covers superficial tumors 3 cm or greater. 27048 is specifically for subfascial tumors under 5 cm; 27049 is for subfascial tumors 5 cm or greater. Depth and size together determine the correct code — document both explicitly.

02Can I bill 27048 for a lipoma excision in the hip region?

Yes, if the lipoma is subfascial (intramuscular) and measures under 5 cm. A subcutaneous lipoma uses a different code family. Pathology confirming lipoma supports the diagnosis, but depth in the operative note determines which 270xx code applies.

03How does the 90-day global affect billing for post-op complications?

Complications requiring a return to the OR for a related procedure bill with modifier 78. An unrelated procedure during the 90-day global uses modifier 79. Routine office visits for wound management are bundled and cannot be separately billed without modifier 24 tied to a distinct, unrelated diagnosis.

04If two separate soft-tissue tumors are excised from the hip on the same day, how do I bill?

Bill 27048 for the primary lesion and the appropriate code for the second lesion with modifier 59 to indicate a distinct procedural service. Each lesion needs its own size and depth documentation in the operative report. Without modifier 59, the second code will likely deny as a duplicate.

05Does the site of service affect what the surgeon gets paid for 27048?

Yes. In a facility setting (HOPD or ASC), the surgeon bills for the professional work component only. The facility bills the technical component separately. In a non-facility setting such as an office-based OR, the surgeon captures both components, reflected in the higher non-facility RVU. Verify your place-of-service code matches where the procedure was actually performed.

06Is pre-operative imaging required to bill 27048?

CMS does not mandate imaging as a billing prerequisite, but most payers expect MRI or CT documentation supporting the depth characterization (subfascial) before authorizing excision. An operative note that contradicts or lacks pre-op imaging findings is an audit target — reference the imaging study in your note.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures tumor depth (subfascial vs. subcutaneous), measured specimen size in centimeters, and the specific anatomic location within the hip or pelvis from the surgeon's dictation. It flags operative notes that lack explicit size or depth language before the claim is built — preventing the most common denial reason for this code: missing documentation to support subfascial depth under 5 cm.

See how Mira captures CPT 27048 documentation