Incision and drainage of a deep abscess, hematoma, or bursa located within the thigh or knee region, requiring dissection through subcutaneous tissue into fascia or muscle.

Verified May 8, 2026 · 6 sources ↓

Medicare: $720.12
Total RVUs: 21.56
Global, days: 90
Region: Knee

Drawn from CMSAAOSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note confirming dissection depth — specifically whether fascia or muscle was entered
Anatomical location of the lesion (thigh vs. knee region, and laterality — left or right)
Characterization of the lesion type: abscess, hematoma, or bursa
Indication for surgery including failed conservative measures or clinical urgency
Anesthesia type used, supporting the surgical (not office) setting
Wound management details: irrigation, packing, drain placement if applicable

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 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27301 covers open incision and drainage of a deep-seated abscess, hematoma, or bursa in the thigh or knee. The operative field is entered through a skin incision overlying the lesion, with dissection carried through deep subcutaneous tissue and potentially into fascia or muscle to fully access and evacuate the collection. This is a substantially deeper procedure than a simple I&D (10060/10061) and is typically performed in an OR or ASC under anesthesia — not in an office setting.

The 90-day global period means all routine post-op care through day 90 is bundled into the payment. If an unrelated E/M visit or procedure occurs during that window, append modifier 24 or 79 respectively. If a related complication requires a return to the OR, use modifier 78. Modifier 57 applies to the decision-for-surgery E/M made the day of or day before the procedure.

This code is billed by orthopedic surgeons most frequently, but also appears in vascular surgery and — less appropriately — family practice. Payer scrutiny is higher when 27301 is billed from a non-surgical setting; documentation must clearly support the depth of dissection to justify this code over a superficial I&D alternative.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.61
Practice expense RVU	13.51
Malpractice RVU	1.44
Total RVU	21.56
Medicare national rate	$720.12
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	$720.12
HOPD (APC 5073) Hospital outpatient department	$2,967.63
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,248.36

Common denial reasons

The recurring reasons claims for CPT 27301 get rejected.

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

Billed from an office setting without documentation supporting depth of dissection into fascia or muscle
Missing laterality — payers expect LT or RT modifier; claims without it are returned or denied
Code mismatch: payer downcodes to 10060/10061 when operative note does not clearly distinguish deep from superficial I&D
Global period conflict — procedure billed during a prior surgical global without the correct modifier (78 or 79)
Missing or inconsistent ICD-10 diagnosis code (e.g., abscess vs. hematoma vs. bursitis) that doesn't align with the CPT selected

Frequently asked questions

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

01When does 27301 apply instead of 10060 or 10061?

Use 27301 when dissection extends into deep subcutaneous tissue and enters or traverses fascia or muscle in the thigh or knee. 10060/10061 are for superficial abscess drainage. If the operative note doesn't document that depth, expect a downcode.

02Can 27301 be billed from an office setting?

Technically possible, but rarely defensible. The code requires depth of dissection that typically necessitates an OR or ASC and anesthesia. Payers flag 27301 billed from office settings, and the documentation burden to support it is high. Many family practice claims for this code get denied or audited.

03What modifier is needed when 27301 is billed same-day with an E/M?

If you're documenting the decision for surgery at the same visit, append modifier 57 to the E/M — this is a 90-day global procedure. If the E/M addresses a separate, unrelated problem on the same day, use modifier 25 on the E/M instead.

04Is laterality required for 27301?

Yes. Append LT or RT to identify which extremity. Claims submitted without laterality are frequently rejected or pended by commercial payers and Medicare Advantage plans.

05What modifier applies if the patient returns to the OR during the 90-day global for a related problem?

Modifier 78 — unplanned return to the OR for a complication or related condition during the global period. Do not use modifier 79 here; that is for an unrelated procedure. Getting these inverted is a common audit finding.

06Can 27301 be billed with modifier 50 for bilateral procedures?

Bilateral deep thigh or knee I&D in the same session is uncommon but not impossible. If performed bilaterally, append modifier 50 and expect the second side to be reimbursed at a reduced rate per standard multiple procedure rules.

07What ICD-10 codes are commonly paired with 27301?

Common diagnoses include L02.415 (abscess, lower extremity), M70.5x (bursitis of knee), and S70-series codes for thigh hematoma following trauma. The diagnosis must match the lesion type documented in the operative note — payers cross-check this.

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 from dictation — whether the surgeon entered subcutaneous tissue only or continued into fascia or muscle — along with the lesion type (abscess, hematoma, or bursa), anatomical location, and laterality. This prevents the most common downcode denial, where auditors reclassify 27301 to a superficial I&D code because the operative note didn't explicitly document the tissue planes entered.

See how Mira captures CPT 27301 documentation