Radical resection of a suspected malignant soft tissue tumor in the thigh or knee area, with the tumor and resection margins measuring less than 5 cm in greatest dimension.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $965.95
- Total RVUs
- 28.92
- Global, days
- 90
- Region
- Knee
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Specify tumor location precisely — thigh versus knee area — and tissue plane depth (subcutaneous vs. subfascial/intramuscular).
- Document the measured diameter of the tumor plus resection margins, confirming the total is less than 5 cm to justify this code over 27364.
- State the clinical suspicion or confirmed diagnosis of malignancy (e.g., sarcoma) driving the radical versus simple excision approach.
- Describe the extent of tissue removed, including the margin of normal surrounding tissue excised with the specimen.
- Record final or intraoperative pathology results and specimen orientation when available, correlating with the operative note.
- Document that a separate imaging study (MRI preferred) was performed pre-operatively to characterize the lesion and plan surgical margins.
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 5 cited references ↓
CPT 27329 describes a wide-margin surgical excision of a soft tissue tumor — typically a suspected sarcoma or other malignant neoplasm — located in the thigh or knee region, where the combined tumor and margin diameter is under 5 cm. This is a radical resection, meaning the surgeon removes not just the mass but also a cuff of surrounding normal tissue to achieve oncologic margins. It is not a simple excision; the extent of dissection required for negative margins at this anatomic site drives the high RVU assignment and 90-day global period.
The 90-day global covers the surgery, the day-before pre-op visit, and all routine post-op care through day 90. Any E/M visit unrelated to the tumor resection and its recovery during that window requires modifier 24. If you're billing a separate, unrelated procedure during the global, append modifier 79. An unplanned return to the OR for a complication directly related to the resection takes modifier 78.
For cases where the tumor and margin diameter equals or exceeds 5 cm, move to CPT 27364 (radical resection, thigh or knee, 5 cm or greater). For excision of a femur or knee bony tumor itself, 27365 is the applicable code. Simple excision of a benign soft tissue tumor in this region falls under 27327 or 27328 depending on depth — 27329 is reserved for procedures performed with the intent of oncologic clearance.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 15.33 |
| Practice expense RVU | 10.11 |
| Malpractice RVU | 3.48 |
| Total RVU | 28.92 |
| Medicare national rate | $965.95 |
| 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 | $965.95 |
HOPD (APC 5073) Hospital outpatient department | $2,967.63 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $1,248.36 |
Common denial reasons
The recurring reasons claims for CPT 27329 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Tumor size not documented or ambiguous — payers default to the lower-complexity code when the note omits measured dimensions.
- Medical necessity not established when pre-operative imaging or biopsy confirming malignant or malignant-potential pathology is absent from the record.
- Upcoding flag when the operative note describes a simple excision technique without clear documentation of wide oncologic margins, triggering a downcode to 27327 or 27328.
- Bundling with concurrent knee procedures (e.g., synovectomy 27334-27335) under NCCI edits — same-day knee procedures require modifier 59 or XS when truly separate and distinct.
- Global period conflicts when post-op E/M visits are billed without modifier 24 and are not clearly unrelated to the resection.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01What separates 27329 from 27327 and 27328?
02When does the tumor size push you to 27364 instead?
03Can 27329 and a knee arthroscopy be billed on the same date?
04What modifier is required if the surgeon returns to the OR within the 90-day global for a wound complication?
05Is pre-operative biopsy required to support medical necessity for 27329?
06Which place of service is typical for 27329 and does it affect payment?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01aapc.comhttps://www.aapc.com/codes/cpt-codes/27329
- 02findacode.comhttps://www.findacode.com/cpt/27329-cpt-code.html
- 03mdclarity.comhttps://www.mdclarity.com/cpt-code/27329
- 04cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 05CMS Physician Fee Schedule 2026
Mira AI Scribe
Mira's AI scribe captures the tumor's anatomic site, depth plane, measured dimensions with margins, clinical suspicion of malignancy, and the extent of surrounding tissue resected — the exact data points that distinguish 27329 from a simple excision code. This prevents downcodes to 27327 or 27328 and blocks medical necessity denials that stem from operative notes that describe the mass but omit size measurements or the oncologic rationale for radical margins.
See how Mira captures CPT 27329 documentation