Soft tissue repair · Hip

27075

Radical resection of a tumor involving a wing of the ilium, one pubic or ischial ramus, or the symphysis pubis, with removal of a margin of surrounding healthy tissue.

Verified May 8, 2026 · 5 sources ↓

Medicare
$1,858.43
Total RVUs
55.64
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 5 cited references ↓

  • Operative note must name the specific anatomic structure resected (iliac wing, pubic ramus, ischial ramus, or symphysis pubis) — 'pelvic tumor excision' alone is insufficient.
  • Document the radical nature of the resection: explicit description of tumor margins removed and width of normal tissue excised on each side.
  • Pre-operative imaging (CT, MRI, or PET) confirming tumor location, size, and extent within the named pelvic structure.
  • Pathology report confirming the specimen submitted, ideally with margin status — auditors cross-reference the operative note to the path report.
  • If modifier 22 is appended, include a separate summary letter documenting increased operative time, unusual tumor extent, or anatomic complexity that distinguishes the case from a typical 27075.
  • ICD-10 diagnosis must specify the tumor type and site; a mismatch between diagnosis code (benign vs. malignant vs. uncertain behavior) and the clinical record is a common claim flag.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27075 covers radical resection of a pelvic/hip tumor — specifically a wing of the ilium, a single pubic or ischial ramus, or the symphysis pubis. Radical resection means the surgeon removes the tumor plus a cuff of normal tissue on all sides; this is not a simple excision or curettage. The code sits in the Excision Procedures on the Pelvis and Hip Joint family and carries a 90-day global period.

The 90-day global covers the day-before visit, the surgery itself, and all routine post-op management through day 90. Separate E/M visits within that window require modifier 24 (unrelated) or 25 (same-day, separate problem). Staged or planned return procedures within the global need modifier 58; unplanned returns for a related complication use modifier 78; unrelated procedures in the global use modifier 79.

Because this is an extensive oncologic resection, modifier 22 is defensible when operative time or complexity significantly exceeds the typical case — but attach a cover letter with the operative note summarizing what drove the increased work. Site-of-service matters: HOPD and ASC payments differ materially (see the Site of Service comparison table on this page). Most payers require pathology-confirmed diagnosis and pre-operative imaging for prior authorization.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU31.89
Practice expense RVU16.96
Malpractice RVU6.79
Total RVU55.64
Medicare national rate$1,858.43
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$1,858.43
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 27075 get rejected.

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

  • Diagnosis code does not support radical resection — benign lesion diagnosis submitted without documentation of aggressive local behavior or surgeon rationale for radical margins.
  • Operative note describes a simple excision or curettage rather than a true radical resection with surrounding normal-tissue margins, causing downcoding or denial.
  • Missing prior authorization: most commercial payers and Medicare Advantage plans require pre-auth for pelvic tumor resections at this RVU level.
  • Site-of-service mismatch: claim billed to HOPD rate but facility submitted as freestanding ASC, or vice versa, triggering payment reconciliation.
  • Unbundling of biopsy performed at the same session without appropriate modifier — a biopsy integral to the resection is not separately reportable.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What distinguishes 27075 from a lesser hip tumor excision code?
27075 is radical resection — the surgeon removes the tumor plus a margin of surrounding normal tissue. Codes for deep or superficial excision without radical margins are coded differently. If the operative note doesn't describe that margin, the claim is vulnerable to downcode.
02Can 27075 be billed with a same-day biopsy?
Only if the biopsy was a separately identifiable procedure at a distinct site or time, not the incisional portion of the resection itself. If the biopsy is integral to the radical resection, it bundles in. Append modifier 59 with strong documentation if billing separately is justified.
03When is modifier 22 appropriate for 27075?
When the procedure was substantially more work than the typical case — for example, unusually large tumor, prior radiation field, or complex vascular anatomy requiring additional dissection. Attach an operative summary letter; without it, most payers auto-deny modifier 22 requests.
04Does the 90-day global period affect post-op oncology visits?
Routine surgical follow-up is bundled through day 90. Oncology-directed visits unrelated to the surgical wound — such as chemotherapy management — can be billed separately with modifier 24 and a distinct diagnosis code. Document clearly that the visit addressed a problem outside the surgical package.
05Is 27075 performed bilaterally?
The symphysis pubis is midline; bilateral reporting doesn't apply there. For iliac wing or ramus involvement, if both sides are resected in one session, report each side on a separate claim line with modifiers LT and RT (ASC) or follow your MAC's bilateral surgery rules for HOPD.
06What ICD-10 codes typically support 27075?
Primary malignant neoplasm of pelvic bones (C41.4), secondary malignant neoplasm of bone (C79.51), and certain aggressive benign diagnoses (e.g., giant cell tumor of bone, D16.8) are the strongest supports. A benign lipoma or cyst diagnosis paired with 27075 will draw scrutiny — document why radical margins were clinically necessary.

Mira AI Scribe

Mira's AI scribe captures the specific anatomic structure resected (iliac wing, pubic ramus, ischial ramus, or symphysis pubis), the extent of normal-tissue margins taken on each side, estimated blood loss, and operative time directly from surgeon dictation. That structured capture prevents the most common audit flag for 27075 — an operative note that documents tumor removal without describing the radical margin, which auditors use to downcode to a lesser excision.

See how Mira captures CPT 27075 documentation

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