Surgical removal of a tumor 5 cm or larger from the intramuscular tissue of the thigh or knee region.

Verified May 8, 2026 · 5 sources ↓

Medicare: $714.45
Work RVU: 10.85
Global, days: 90
Region: Knee

Drawn from CMSAAPCMedical-codingAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Tumor size documented in centimeters — must confirm ≥5 cm to support 27339 over lower-threshold codes
Anatomic depth confirmed as intramuscular, not subcutaneous or subfascial
Specific anatomic location within the thigh or knee region identified in the operative note
Operative note describes approach and extent of resection, not just 'standard excision'
Pathology report linked to the specimen to support the diagnosis code assigned
Pre-operative imaging (MRI preferred) supporting tumor size and depth characterization

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 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

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27339 covers open excision of a soft-tissue tumor located in the intramuscular compartment of the thigh or knee, measuring 5 cm or greater in its greatest dimension. The size threshold and depth (intramuscular) are what distinguish 27339 from smaller or more superficial lesion codes — get either wrong and expect a downcoding. Note that 27337–27339 are resequenced codes and will not appear in consecutive numeric order in the CPT manual.

The 90-day global period means all routine post-op care — wound checks, staple removal, hematoma drainage that's part of normal healing — is bundled into the surgical payment. Any return to the OR for a complication related to the original excision bills under modifier 78. An unrelated procedure during the global window needs modifier 79. A separate E/M visit for a distinct problem during the 90-day period requires modifier 24.

Site of service matters significantly here: HOPD and ASC payment rates differ substantially (see the Site of Service comparison table). Pathology drives the ICD-10 selection; do not assign a malignant diagnosis code until the pathology report confirms it. An excisional biopsy is not separately reportable when a therapeutic excision is performed at the same encounter.

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 (10.85) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (21.39) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	10.85
Practice expense RVU	8.02
Malpractice RVU	2.52
Total RVU	21.39
Medicare national rate	$714.45
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	$714.45
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 27339 get rejected.

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

Upcoding flag: tumor size not documented at ≥5 cm in the operative note or pre-op imaging
Depth mismatch: lesion documented as subcutaneous rather than intramuscular, triggering downcoding to 27337 or 27327
Separate billing of excisional biopsy at the same encounter — bundled into the therapeutic excision and not separately payable
ICD-10 diagnosis coded as malignant before pathology confirmation, triggering medical necessity review
Modifier absent when billing a related return-to-OR procedure during the 90-day global period

Frequently asked questions

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

01What separates 27339 from 27337 and 27338?

27339 requires the tumor to be intramuscular and ≥5 cm. Codes 27337 and 27338 cover smaller or more superficial lesions. Depth and size both have to match — intramuscular and ≥5 cm — to support 27339.

02Can I bill a separate excisional biopsy if I also performed a therapeutic excision at the same encounter?

No. When a therapeutic excision is performed, an excisional biopsy at the same site and encounter is not separately reportable. The biopsy work is considered part of the definitive procedure.

03What modifier applies if the patient returns to the OR during the 90-day global for a wound dehiscence related to the original excision?

Modifier 78 — unplanned return to the OR for a procedure related to the original surgery during the postoperative period. Do not use modifier 79, which is reserved for unrelated procedures.

04Should I assign a malignant ICD-10 code before pathology results are back?

No. Assign an unspecified or uncertain neoplasm code until the pathology report confirms the diagnosis. Premature assignment of a malignant code can trigger medical necessity review and payer audit.

05Does site of service affect reimbursement for 27339?

Yes, significantly. HOPD and ASC rates differ — refer to the Site of Service comparison table on this page. Factor this into case scheduling decisions, especially for high-cost tumor cases.

06Can modifier 22 be used for an unusually complex excision?

Yes, if the operative complexity was substantially greater than typical — for example, due to tumor adherence to neurovascular structures or extensive reconstruction needed after removal. Document the specific factors that increased work in the operative report; without that, payers will deny or ignore the modifier.

Sources & references

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

Mira Scribe

Mira's AI scribe captures tumor size in centimeters, tissue depth (intramuscular vs. subcutaneous), and the specific anatomic location within the thigh or knee directly from surgeon dictation. It flags operative notes that omit a measured dimension or describe depth ambiguously — the two documentation gaps most likely to trigger a size-based downcoding or a depth-based denial during post-payment audit.

See how Mira captures CPT 27339 documentation