Open excision of a subcutaneous soft-tissue tumor of the thigh or knee area measuring less than 3 cm in greatest dimension.

Verified May 8, 2026 · 6 sources ↓

Medicare: $539.42
Total RVUs: 16.15
Global, days: 90
Region: Knee

Drawn from CMSAAPCFindacodeNIH

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Intraoperative measurement of the lesion — size in centimeters, documented in the operative note, not just the pathology report
Explicit confirmation of subcutaneous depth (above the fascia); note must distinguish from deep/subfascial location
Anatomic location within the thigh or knee area, with laterality (left vs. right)
Operative approach and technique, including how the lesion was identified, dissected, and removed
Pathology specimen submission documentation confirming the excised tissue was sent for analysis
Post-operative wound closure method and condition of surrounding tissue

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 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another 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 6 cited references ↓

27327 covers surgical removal of a subcutaneous soft-tissue mass — lipoma, ganglion, or other benign tumor — located in the thigh or knee region, where the lesion measures under 3 cm. The lesion must reside in the subcutaneous layer, not the deep subfascial or intramuscular plane. If the tumor is 3 cm or larger at the subcutaneous level, step up to 27337. If the mass is deep (subfascial or intramuscular) and under 5 cm, use 27328 instead.

Size and depth are the two variables that drive code selection across this family. Document both explicitly in the operative note — not just the gross specimen size, but the intraoperative measurement of the lesion as encountered. Pathology report size alone is insufficient for audit purposes, since fixation can alter dimensions.

27327 carries a 90-day global period. Routine post-op visits, wound checks, and suture removal through day 90 are included in the global package and cannot be billed separately. Any E/M service for an unrelated condition during that window requires modifier 24.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.86
Practice expense RVU	11.42
Malpractice RVU	0.87
Total RVU	16.15
Medicare national rate	$539.42
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	$539.42
HOPD (APC 5072) Hospital outpatient department	$1,687.37
ASC (PI G2) Ambulatory surgical center (freestanding)	$742.04

Common denial reasons

The recurring reasons claims for CPT 27327 get rejected.

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

Size not documented in the operative note — payers reject claims when only the pathology report lists dimensions
Depth ambiguity: note fails to confirm subcutaneous (vs. subfascial) plane, triggering a mismatch with 27328 or 27329
Lesion size at or above 3 cm with 27327 billed — should have been coded to 27337
Separate E/M billed during the 90-day global period without modifier 24 for an unrelated diagnosis
Missing laterality — claims without LT or RT modifier are frequently rejected by commercial payers requiring side designation

Frequently asked questions

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

01What's the difference between 27327, 27337, 27328, and 27329?

All four codes cover soft-tissue tumor excision in the thigh/knee. 27327 = subcutaneous, less than 3 cm. 27337 = subcutaneous, 3 cm or greater. 27328 = deep (subfascial/intramuscular), less than 5 cm. 27329 = deep, resection type, less than 5 cm. Size and depth together determine the correct code — you need both documented.

02Can I bill 27327 for a lipoma removal in the thigh?

Yes, if the lipoma is subcutaneous and measures less than 3 cm. Document the intraoperative size explicitly. If the lipoma is subfascial or larger, move to 27328 or 27337 accordingly.

03Does the 90-day global period apply to 27327?

Yes. The global period is 90 days. Routine post-op care, wound checks, and suture removal within that window are bundled and cannot be billed separately. Use modifier 24 on any E/M for an unrelated problem during the global period.

04Is modifier 22 ever appropriate with 27327?

Yes, but document the specific reason — unusually dense adhesions, atypical lesion vascularity, or prolonged operative time with explanation. Modifier 22 without supporting documentation will be denied or downcoded on audit.

05Can 27327 be billed bilaterally on the same date?

If separate lesions are excised from both thighs or both knees on the same date, bill 27327 with LT on one line and RT on the other, and append modifier 51 on the lower-value service. Do not use modifier 50 unless the payer specifically requires it — most prefer separate line items with laterality modifiers for this code.

06What site-of-service difference should I know about for 27327?

The HOPD and ASC payment rates differ significantly — see the Site of Service comparison table on this page. For Medicare, the facility rate applies whether performed in a hospital outpatient department or ASC; the non-facility rate applies in an office or other non-facility setting. Confirm the patient's location is accurately reported on the claim.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures intraoperative lesion size (in cm), depth layer (subcutaneous vs. subfascial), anatomic site within the thigh or knee, and laterality directly from dictation. It flags when size approaches or exceeds the 3 cm threshold so coders can evaluate 27337 before the claim drops — preventing the most common denial reason for this code family.

See how Mira captures CPT 27327 documentation