Surgical · Hip

Excision of a bone cyst or benign tumor from the iliac wing, symphysis pubis, or greater trochanter of the femur, with autogenous bone grafting through a separate incision to reconstruct the defect.

Verified May 8, 2026 · 7 sources ↓

Medicare: $957.27
Total RVUs: 28.66
Global, days: 90
Region: Hip

Drawn from CMSMdclarityAAPCFindacodeAAOS

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify the exact anatomic location of the lesion: iliac wing, symphysis pubis, or greater trochanter of the femur — vague site descriptions trigger downcoding or denial
Document the pathologic nature of the lesion (bone cyst vs. benign tumor) and correlate with preoperative imaging findings
Describe the graft harvest site and confirm it was accessed through a separate incision — this is what distinguishes 27067 from excision-only codes
Record the size and extent of the lesion and the volume of graft used to reconstruct the defect
Include pre- and post-operative ICD-10 diagnosis codes that match the lesion type (e.g., M85.x5x for solitary bone cyst, hip region)
For modifier 22 consideration, document operative time and complexity significantly beyond the typical procedure

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27067 covers surgical removal of a bone cyst or benign tumor from three specific hip-region sites — the wing of the ilium, the symphysis pubis, or the greater trochanter of the femur — combined with autogenous bone grafting to fill the resulting defect. The graft is harvested through a separate incision, typically from the iliac crest or another donor site on the same patient. That graft-harvest component is included in the code; billing a separate graft-harvest code alongside 27067 creates a bundling conflict.

The 90-day global period covers all routine post-op management through day 90. New, unrelated problems addressed during that window require modifier 24 on the E/M and clear documentation that the visit was not for post-op care. A staged or planned second procedure in the global period uses modifier 58; an unplanned return to the OR for a related complication uses modifier 78.

Site selection matters for code accuracy. 27067 is anatomy-specific — iliac wing, symphysis pubis, or greater trochanter only. Lesions on the femoral shaft or femoral head fall under different codes (e.g., 27356–27357). Mismatched anatomy between the operative note and the selected CPT code is a leading audit trigger for this family of excision codes.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	14.35
Practice expense RVU	11.26
Malpractice RVU	3.05
Total RVU	28.66
Medicare national rate	$957.27
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	$957.27
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$5,244.73

Common denial reasons

The recurring reasons claims for CPT 27067 get rejected.

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

Anatomic mismatch: operative note documents a site not covered by 27067 (e.g., femoral shaft), triggering a code selection dispute
Missing graft documentation: payers deny 27067 and downcode to an excision-only code when the operative note does not explicitly describe graft harvest through a separate incision
ICD-10 mismatch: diagnosis code reflects a malignant lesion, which points to a different CPT code family and fails medical necessity review for 27067
Unbundling error: separate billing of a bone graft harvest code alongside 27067, which already includes the autograft component
Global period conflict: post-op E/M claims submitted without modifier 24 during the 90-day global are automatically denied as included services

Frequently asked questions

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

01Does 27067 include the bone graft harvest, or do I bill that separately?

The autogenous graft harvest is included in 27067. Billing a separate graft harvest code alongside it creates a bundling conflict and will be denied. Document the harvest clearly in the operative note so the work is captured within the primary code.

02What if the lesion is on the femoral shaft rather than the greater trochanter?

27067 is restricted to the iliac wing, symphysis pubis, and greater trochanter. Femoral shaft lesions with grafting map to 27356 or 27357 depending on complexity. Using 27067 for a femoral shaft site is a code selection error that will surface on audit.

03Can I bill 27067 bilaterally?

Bilateral same-session excisions at eligible sites require modifier 50, with the primary code listed once. Some payers instead require LT and RT on two line items. Confirm payer-specific bilateral billing rules before submitting — Medicare generally accepts modifier 50, but many commercial payers differ.

04What modifier applies if I need to take the patient back to the OR during the 90-day global for a related complication?

Use modifier 78 for an unplanned return to the OR for a complication related to the original procedure within the global period. Modifier 79 applies only to unrelated procedures. Inverting these is a frequent audit finding.

05How do I bill an E/M visit during the 90-day global for a new, unrelated problem?

Append modifier 24 to the E/M code and document clearly in the note that the visit addressed a problem unrelated to the hip lesion surgery. Without modifier 24 and that documentation, the claim is denied as included in the global.

06Is 27067 appropriate for malignant bone tumors of the hip?

No. 27067 is specifically for bone cysts and benign tumors. Malignant lesions of the pelvis and hip require codes from the tumor resection range. Submitting 27067 with a malignant diagnosis ICD-10 code will fail medical necessity review.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the exact lesion site (iliac wing, symphysis pubis, or greater trochanter), lesion type (cyst or benign tumor), and confirms documentation of the separate graft-harvest incision and donor site from surgeon dictation. This prevents the two most common denials for 27067: anatomic mismatch and missing graft documentation that cause payers to downcode or reject the claim outright.

See how Mira captures CPT 27067 documentation