Open surgical removal of the ischial bursa, a fluid-filled sac overlying the ischial tuberosity at the base of the pelvis, performed to treat refractory ischial bursitis.

Verified May 8, 2026 · 6 sources ↓

Medicare: $450.58
Total RVUs: 13.49
Global, days: 90
Region: Hip

Drawn from CMSAAPCMdclarityNIH

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Diagnosis of ischial bursitis with documented chronicity and prior conservative treatment failure, including steroid injection history
Pre-operative imaging (MRI or ultrasound) confirming bursal enlargement or inflammation at the ischial tuberosity
Operative note specifying patient positioning (prone, hips flexed), incision location, aspiration of bursal contents, and complete excision of the bursal sac
Laterality clearly stated (left vs. right ischium) in both the operative note and the diagnosis
Pathology submission documentation if bursal tissue is sent for histologic analysis
Drain placement and closure technique noted to support complexity and post-op management billing

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 52 Reduced services 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27060 describes open excision of the ischial bursa — the bursal sac that sits between the gluteus maximus and the ischial tuberosity. The procedure is reserved for cases where conservative management (injections, physical therapy) has failed. Surgically, the patient is positioned prone with hips flexed, a longitudinal incision is made over the palpable bursa, the sac is aspirated and then excised in its entirety from the ischial bone, and soft tissue is approximated tightly to eliminate dead space. A closed suction drain is typically placed before closure.

The 90-day global period covers all routine post-op care through day 90, including wound checks and drain removal. Any unrelated procedure billed within that window requires modifier 79; a related return to the OR requires modifier 78. Because this is a unilateral site by anatomy (left or right ischium), use LT or RT whenever laterality is clinically documented — and modifier 50 only if bilateral excision is performed at the same operative session, which is rare.

Ischial bursectomy is documented in the orthopedic and general surgery literature, but CMS PUF data show no dominant billing specialty for 27060, meaning payer medical necessity criteria vary. Expect scrutiny: most payers require documented failure of at least one steroid injection and imaging confirmation (MRI or ultrasound) of bursal pathology before authorizing surgical excision.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.72
Practice expense RVU	6.55
Malpractice RVU	1.22
Total RVU	13.49
Medicare national rate	$450.58
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	$450.58
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,682.29

Common denial reasons

The recurring reasons claims for CPT 27060 get rejected.

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

Medical necessity denied when conservative treatment failure (injections, PT) is not documented in the chart before surgery
Missing or ambiguous laterality causes claim rejection or downcoding when LT/RT modifier is absent
Bundling denials when a same-day injection or aspiration code is billed without modifier 59 establishing it as a distinct service
Global period denials for post-op E/M visits billed without modifier 24 (unrelated) or 79 (unrelated procedure) within the 90-day window
Prior authorization not obtained despite payer policy requiring it for elective bursectomy

Frequently asked questions

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

01What is the global period for CPT 27060?

90 days. All routine post-op visits, wound checks, and drain removal are bundled through day 90. Bill modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures within that window.

02Does 27060 require prior authorization?

Most commercial payers require it. Standard criteria include documented failure of conservative care — typically at least one corticosteroid injection plus physical therapy — and imaging confirmation of bursitis. Verify with each payer before scheduling.

03Can I bill 27060 bilaterally?

Bilateral ischial bursectomy at a single operative session is unusual but billable with modifier 50. Document each side distinctly in the operative note. Reimbursement is generally capped at 150% of the single-procedure allowable under Medicare.

04How does 27060 differ from 27062?

27060 is excision of the ischial bursa. 27062 covers the trochanteric bursa or calcification near the greater trochanter. Anatomy drives code selection — confirm the operative site on imaging and in the operative note.

05Can I bill a same-day steroid injection separately from 27060?

No — if an injection is performed as part of the surgical workup or intraoperatively, it bundles into 27060. A pre-operative diagnostic injection performed on a different date of service does not bundle.

06What ICD-10 code typically supports 27060 medical necessity?

M70.70 (bursitis of hip, unspecified) or the lateralized variants M70.71 (right) and M70.72 (left) are the primary diagnosis codes. Match the laterality of the ICD-10 code to the LT or RT modifier on the claim.

07Should I use modifier 78 or 79 if the patient returns to the OR during the global period?

Modifier 78 is for an unplanned return to the OR for a procedure related to the original surgery (e.g., wound dehiscence requiring re-closure). Modifier 79 is for an unrelated procedure performed by the same surgeon during the 90-day global. Do not invert these.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures prone positioning, hip flexion, incision length and location over the ischial tuberosity, aspiration technique, complete bursal sac excision from bone, soft-tissue approximation, and drain placement from surgeon dictation. That level of operative detail directly supports medical necessity reviews and prevents denials that cite insufficient documentation of complete excision versus simple aspiration.

See how Mira captures CPT 27060 documentation