Surgical · Hip

27076

Radical resection of a pelvic or hip tumor involving the ilium with acetabulum, both pubic rami, or the ischium with acetabulum — removing the tumor plus a margin of surrounding healthy bone and tissue.

Verified May 8, 2026 · 6 sources ↓

Medicare
$2,232.85
Total RVUs
66.85
Global, days
90
Region
Hip
Drawn from CMSNIHGomedicalbillingAAPCEmedny

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Imaging studies (MRI, CT, PET) confirming tumor location and extent of acetabular involvement
  • Pathology or biopsy report establishing the diagnosis requiring radical resection
  • Operative note specifying which pelvic structure was resected — ilium with acetabulum, both pubic rami, or ischium with acetabulum
  • Documentation of wide-margin (radical) excision technique with notation of surrounding tissue removed
  • Reconstruction method documented if performed — allograft, prosthesis, or other technique billed separately
  • Pre-operative diagnosis linked to a matching ICD-10-CM code for primary or metastatic bone tumor of the pelvis

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 6 cited references ↓

CPT 27076 covers radical resection of bone tumors arising from major pelvic structures — specifically the ilium including the acetabulum, both pubic rami, or the ischium and acetabulum. 'Radical' here means wide-margin en bloc excision: the tumor comes out with a cuff of histologically normal tissue on all sides. This is not a simple curettage or marginal excision. The acetabular involvement is the defining anatomical criterion that separates 27076 from less extensive pelvic tumor codes.

The 90-day global period swallows all routine post-op care through day 90. Any E/M visit in that window billed for the same condition is bundled — no separate payment. Unrelated problems billed during the global need modifier 24; a separate significant E/M on the day of surgery needs modifier 25. Given the complexity of reconstruction that often follows this resection (custom implants, allograft, hip transposition), document each additional procedure separately with the correct code and modifier 51 or 62 as applicable.

Site of service matters here. HOPD and ASC payments differ substantially — see the Site of Service comparison on this page. Most payers require prior authorization for a procedure at this RVU weight; confirm auth is in place before the case, not after.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU39.2
Practice expense RVU19.29
Malpractice RVU8.36
Total RVU66.85
Medicare national rate$2,232.85
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
$2,232.85
HOPD (APC 5114)
Hospital outpatient department
$7,413.38
ASC (PI G2)
Ambulatory surgical center (freestanding)
$3,695.53

Common denial reasons

The recurring reasons claims for CPT 27076 get rejected.

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

  • Missing or mismatched ICD-10-CM diagnosis — payer rejects if the tumor code doesn't map to a pelvic or acetabular site
  • Lack of prior authorization — most commercial payers require auth for high-RVU oncologic resections
  • Operative note describes curettage or marginal excision rather than radical wide-margin resection, undercutting medical necessity for 27076
  • Unbundling flags when reconstruction codes are billed without modifier 51 or appropriate linkage to the primary procedure
  • Global period violations — post-op E/M visits for the same condition billed without modifier 24 within the 90-day window

Frequently asked questions

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

01What distinguishes CPT 27076 from other pelvic tumor excision codes?
27076 requires radical resection — wide-margin en bloc removal — of the ilium including the acetabulum, both pubic rami, or the ischium and acetabulum. Codes for more limited pelvic excisions (e.g., tumor of the wing of the ilium without acetabular involvement) are reported separately. Acetabular involvement is the anatomical key for 27076.
02Can reconstruction be billed separately when performed at the same session?
Yes. Reconstruction — whether a custom acetabular prosthesis, allograft, or hip transposition — is a distinct procedure and should be billed with its own CPT code. Append modifier 51 to the secondary procedure, or modifier 62 if two surgeons each perform distinct portions. Document both procedures separately in the operative note.
03What modifiers are needed if a second surgery is required within the 90-day global?
If the return surgery is related to the original resection (e.g., wound complication, hardware failure tied to the original procedure), use modifier 78. If it is a completely unrelated procedure performed during the global period, use modifier 79. Never invert these — wrong modifier use is a common audit finding.
04Is modifier 22 appropriate for 27076?
Yes, if the resection required substantially increased work beyond the typical case — for example, unusually large tumor size, prior radiation field, or involvement extending beyond the standard anatomical boundaries. Attach a letter of medical necessity and document the added complexity explicitly in the operative note. Modifier 22 without supporting documentation is routinely denied.
05Does site of service affect reimbursement for 27076?
Yes. HOPD and ASC payments differ — see the Site of Service comparison on this page. Most radical pelvic tumor resections occur in a hospital setting. Verify your facility's contract terms, because the gap between HOPD and ASC rates is substantial for a procedure at this RVU level.
06Which ICD-10-CM codes are typically linked to 27076?
Primary malignant neoplasms of pelvic bones (C41.4) and metastatic bone disease involving the pelvis are the most common diagnoses. Aggressive benign tumors requiring radical margins (e.g., giant cell tumor of the acetabulum) also support this code. The site in the ICD-10-CM code must match the operative site documented — mismatch is a top denial driver.

Mira AI Scribe

Mira's AI scribe captures the specific pelvic structure resected (ilium with acetabulum, both pubic rami, or ischium with acetabulum), the surgical margin description, and any reconstruction performed — exactly what auditors check to validate 27076 over lower-level pelvic excision codes. That prevents downcoding denials and operative-note-insufficiency flags on post-payment review.

See how Mira captures CPT 27076 documentation

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