Open excision of a cyst or ganglion arising from the meniscus or joint capsule of the knee.
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $508.03
- Total RVUs
- 15.21
- 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 6 cited references ↓
- Specify the exact anatomic origin of the lesion — meniscus versus joint capsule — and laterality (medial or lateral compartment).
- Confirm the surgical approach is open; do not use 27347 for a purely arthroscopic decompression or excision.
- Document lesion type (cyst, ganglion, or other), size, and pre-operative imaging or clinical findings supporting medical necessity.
- Include a step-by-step operative note describing skin incision, dissection plane, lesion identification, excision at the base, and closure technique.
- Note any pathology specimen submission — payers may request the pathology report to validate a cyst or ganglion diagnosis.
- Record laterality explicitly (left vs. right knee) in both the operative note and the diagnosis coding to support LT/RT modifier use.
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 6 cited references ↓
CPT 27347 covers an open surgical excision of a lesion — typically a cyst or ganglion — originating from the meniscus or knee joint capsule. The surgeon incises through skin and soft tissue to directly access the lesion, excises it at its base, and closes the wound. This is an open procedure; if the cyst is decompressed or addressed entirely arthroscopically, 27347 is not the correct code.
The 90-day global period means all routine post-op visits, wound checks, and stitch removals through day 90 are bundled. Anything unrelated billed in that window requires modifier 24 (E/M) or 79 (unrelated procedure). A same-day E/M requires modifier 25 on the evaluation and management code.
Differentiating from nearby codes matters here: 27345 covers a popliteal (Baker's) cyst specifically; 27340 covers prepatellar bursa; and arthroscopic parameniscal cyst decompression does not map cleanly to 27347 — operative notes describing an arthroscopic approach alongside open excision may only support one code, and NCCI policy bars reporting a converted-arthroscopy-to-open scenario with both codes.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 6.56 |
| Practice expense RVU | 7.31 |
| Malpractice RVU | 1.34 |
| Total RVU | 15.21 |
| Medicare national rate | $508.03 |
| 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 | $508.03 |
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 27347 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Missing or ambiguous laterality — claim billed without LT or RT modifier triggers automated rejection at many payers.
- Arthroscopic approach documented in the operative note but open code 27347 billed — payers and auditors flag this mismatch.
- Insufficient medical necessity documentation; no imaging, clinical exam findings, or failed conservative treatment noted pre-operatively.
- Incorrect code selection when the lesion is a Baker's (popliteal) cyst — that maps to 27345, not 27347.
- Global period conflict — an E/M or related procedure billed within the 90-day global without the appropriate modifier (24, 25, or 79).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01Can 27347 be billed for an arthroscopic parameniscal cyst decompression?
02What's the difference between 27347 and 27345?
03Do LT and RT modifiers matter for 27347?
04How does the 90-day global period affect same-day billing?
05When is modifier 22 appropriate for 27347?
06Can 27347 and a knee arthroscopy code be billed together on the same day?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/files/document/2026-ncci-medicaid-policy-manual.pdf
- 03cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicaid-policy-manual-2025finalcleanpdf.pdf
- 04abos.orghttps://www.abos.org/wp-content/uploads/2019/12/sports-cpt-updated.pdf
- 05aaos.orghttps://www.aaos.org/globalassets/advocacy/issues/aaos-specialty-care-reimbursement-model.pdf
- 06medicare.govhttps://www.medicare.gov/procedure-price-lookup/cost/27347/
Mira AI Scribe
Mira's AI scribe captures the lesion's anatomic origin (meniscus vs. capsule), surgical approach (open incision with direct excision vs. any arthroscopic component), laterality, and lesion characteristics from dictation. This prevents the most common audit flag: an operative note that describes an arthroscopic technique billed under the open excision code 27347, and ensures laterality modifiers LT or RT are populated before the claim goes out.
See how Mira captures CPT 27347 documentation