Surgical removal of a foreign body from deep tissue of the pelvis or hip, at the subfascial or intramuscular level.

Verified May 8, 2026 · 7 sources ↓

Medicare: $596.54
Work RVU: 8.61
Global, days: 90
Region: Hip

Drawn from CMSCgsmedicareFindacodeAAPC

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Operative note must explicitly state subfascial or intramuscular depth of dissection — not just 'deep' without anatomic qualifier.
Describe the foreign body by type (e.g., retained hardware fragment, bullet, clip) and its anatomic location within the pelvis or hip.
Document the surgical approach and layers dissected to reach the foreign body.
Imaging or diagnostic studies (X-ray, CT, fluoroscopy) used to localize the foreign body preoperatively or intraoperatively.
If fluoroscopy was used intraoperatively to guide removal, note whether it was separately billable or integral to the procedure.
Specify laterality (left or right hip) to support LT/RT modifier use and avoid laterality-based denials.

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 52 Reduced services 58 Staged or related 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27087 covers open surgical extraction of a foreign body lodged in the deep soft tissue of the pelvis or hip — subfascial or intramuscular depth. This distinguishes it from superficial foreign body removal (27086), which doesn't require dissection through fascial layers. Typical foreign bodies include retained surgical hardware fragments, broken instruments, bullets, or other objects that have migrated into deep hip or pelvic tissue and cannot be removed without operative dissection.

The code carries a 90-day global period. Any evaluation or separate procedure billed during that window needs the appropriate modifier — 24 for unrelated E/M, 78 for an unplanned return to the OR for a related complication, or 79 for an unrelated procedure during the global. Document depth of dissection explicitly; without clear operative note language confirming subfascial or intramuscular access, payers will question whether 27086 (superficial) was the correct code.

Site of service matters here. HOPD and ASC payment rates differ substantially — see the site-of-service comparison table. If removal is incidental to a larger hip procedure performed the same day, check NCCI bundling before billing both codes. The NCCI Medicaid policy manual flags that foreign body removal codes should not be reported separately when the removal is integral to a concurrent arthroplasty or other major hip procedure.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (8.61) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.86) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	8.61
Practice expense RVU	7.26
Malpractice RVU	1.99
Total RVU	17.86
Medicare national rate	$596.54
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	$596.54
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 27087 get rejected.

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

Depth of dissection not documented — payer downcodes to 27086 (superficial removal) without clear subfascial or intramuscular language in the operative note.
Bundling denial when billed same-day with a major hip arthroplasty or reconstruction procedure — NCCI edits may treat foreign body removal as integral.
Laterality modifier missing or inconsistent with imaging or operative report, triggering edit or administrative denial.
Medical necessity not established — no documentation linking the foreign body to the patient's symptoms or clinical indication for surgical removal.
Global period conflict — billed within the 90-day global of a prior hip procedure without a modifier (78 or 79) to identify the relationship to the original surgery.

Frequently asked questions

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

01What separates 27087 from 27086?

Depth. CPT 27086 is for superficial foreign body removal from the pelvis or hip. CPT 27087 requires subfascial or intramuscular dissection. The operative note must confirm the surgeon passed through the fascia to reach the object — that's the documentation threshold that justifies 27087 over 27086.

02Can 27087 be billed the same day as a hip arthroplasty?

Generally no without scrutiny. NCCI policy treats foreign body removal as integral to concurrent major hip procedures when the removal is part of the same operative field. Check NCCI PTP edits for the specific code pairing. If the foreign body removal is truly a distinct, separately identifiable procedure, modifier 59 or XS may apply — but document the clinical distinction clearly.

03Is modifier 50 appropriate if both hips are addressed?

Yes, if foreign bodies are removed from both hips in the same operative session, modifier 50 applies. Alternatively, bill separate line items with LT and RT. Confirm with the payer which billing convention they require — some commercial payers prefer separate lines over modifier 50.

04What modifiers apply if this procedure is done during the global period of a prior hip surgery?

Use modifier 78 if the patient returns to the OR for an unplanned removal of a foreign body related to the original procedure (e.g., a retained fragment from prior surgery). Use modifier 79 if the foreign body is unrelated to the prior procedure. Do not bill without a modifier — the claim will deny as a duplicate or global period conflict.

05Does the 90-day global include postoperative imaging ordered to confirm complete removal?

Routine postoperative imaging ordered to confirm complete foreign body removal is typically included in the global period. Imaging for a new or unrelated clinical concern during the 90-day global can be billed separately with appropriate modifier 24 on any associated E/M, but standalone imaging codes generally don't require a modifier. Check your payer's global period policy for imaging specifics.

06When should modifier 22 be used with 27087?

Use modifier 22 when the removal required substantially more work than typical — for example, a foreign body that had migrated to an unusually deep or complex anatomic location, required extended operative time, or involved significant additional dissection. The operative note must quantify the added complexity. Attach a cover letter explaining the increased work; without one, payer medical reviewers will not adjudicate the upward adjustment.

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 depth of dissection (subfascial vs. intramuscular), foreign body description and anatomic location, layers traversed during the approach, laterality, and any intraoperative imaging used to localize the object. This prevents the most common downcoding denial — auditors flag operative notes that reference 'deep removal' without confirming the dissection crossed the fascial plane, which is the line between 27086 and 27087.

See how Mira captures CPT 27087 documentation