Surgical · Spine

Surgical excision of the coccyx (tailbone), performed as an open procedure to remove the terminal segment of the spine.

Verified May 8, 2026 · 5 sources ↓

Medicare: $500.68
Total RVUs: 14.99
Global, days: 90
Region: Spine

Drawn from CMSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Diagnosis of coccydynia or equivalent, with ICD-10 code supporting medical necessity
Documentation of failed conservative treatment (duration, modalities tried — physical therapy, injections, NSAIDs)
Operative note specifying extent of resection (partial vs. complete coccyx removal) and surgical approach
Preoperative imaging (X-ray, MRI, or CT) confirming coccygeal pathology and ruling out neoplasm
Notation of any concomitant procedures performed and their distinct anatomic or clinical basis
Post-op note confirming specimen sent to pathology if neoplasm was on the differential

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 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27080 covers open surgical removal of the coccyx. It's most commonly indicated for coccydynia refractory to conservative care — including physical therapy, injections, and NSAIDs — typically after 3–6 months of failed non-operative treatment. The procedure involves a posterior midline incision, dissection through the gluteal fascia, and disarticulation or osteotomy at the sacrococcygeal junction. Partial or complete removal is captured under this single code; the operative note should specify extent of resection.

The 90-day global period covers all routine post-op care through day 90. Any E/M visit during that window for a new or unrelated condition requires modifier 24. If a complication requires return to the OR for a related procedure — such as wound débridement at the surgical site — bill with modifier 78. Modifier 79 applies if the return-to-OR procedure is unrelated to the coccygectomy. NCCI PTP edits should be reviewed when billing wound closure or lesion excision codes on the same date; soft-tissue work incidental to the coccygectomy approach is bundled.

Coccygectomy carries meaningful site-of-service payment differential. HOPD and ASC rates differ substantially (see the Site of Service comparison table on this page). ASC is frequently the appropriate and cost-effective setting when the patient is otherwise healthy and the procedure is elective. Payers — including Medicare — require documented failure of conservative treatment before authorizing coccygectomy.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.72
Practice expense RVU	6.58
Malpractice RVU	1.69
Total RVU	14.99
Medicare national rate	$500.68
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	$500.68
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 27080 get rejected.

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

Lack of documented conservative treatment failure prior to surgical authorization
Missing or vague operative note — 'standard approach' without naming dissection planes or extent of resection
Unbundling of incidental soft-tissue work billed separately on the same date without a valid NCCI modifier
Medical necessity not established when pre-op imaging or clinical workup is absent from the record
Modifier 78 or 79 missing or inverted on same-global return-to-OR claims

Frequently asked questions

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

01Does 27080 cover both partial and complete coccygectomy?

Yes. The code doesn't distinguish partial from complete removal. Document the extent of resection in the operative note for audit purposes, but you don't need a separate code for each scenario.

02What's the global period for 27080?

90 days. Routine post-op visits, dressing changes, and suture removal through day 90 are bundled. Bill modifier 24 on any E/M during that window for a new or unrelated problem.

03Can I bill a wound excision or lesion removal code same-day with 27080?

Only if the lesion excision is anatomically and clinically distinct from the coccygectomy approach. Check NCCI PTP edits first. Soft-tissue dissection incidental to accessing the coccyx is bundled — modifier 59 or XS won't override a Column 1/Column 2 edit where the procedures share the same surgical field.

04What modifier applies if the patient returns to the OR for wound dehiscence at the coccygectomy site?

Modifier 78 — unplanned return to the OR for a procedure related to the original surgery during the global period. Don't use 79 here; that's reserved for unrelated procedures.

05What ICD-10 codes typically support 27080?

M53.3 (coccygodynia) is the primary driver. Post-traumatic coccydynia may also be coded with M48.08 or injury sequela codes. Payers expect the diagnosis to align with documented imaging findings and failed conservative care.

06Is prior authorization typically required for coccygectomy?

Most commercial payers and Medicare Advantage plans require it, and the PA criteria almost universally include documented failure of at least 3–6 months of conservative treatment. Submit therapy notes, injection records, and imaging with the PA request to avoid back-and-forth.

07When would modifier 22 apply to 27080?

When the procedure required substantially more work than typical — for example, significant scarring from prior surgery, unusual anatomy, or a large presacral mass encountered intraoperatively. Attach a cover letter quantifying extra time and complexity; payers rarely pay 22 without one.

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 surgical approach, extent of coccyx resection (partial or complete), sacrococcygeal disarticulation versus osteotomy level, and any concomitant soft-tissue dissection from the surgeon's dictation. It also flags whether pre-op conservative treatment duration and modalities are documented in the note — the most common trigger for payer medical necessity denials on 27080.

See how Mira captures CPT 27080 documentation