Decompression fasciotomy of the lower leg targeting the anterior and/or lateral compartments to relieve elevated intracompartmental pressure.

Verified May 8, 2026 · 5 sources ↓

Medicare: $375.76
Total RVUs: 11.25
Global, days: 90
Region: Foot & ankle

Drawn from CMSEmednyAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify which compartments were released: anterior, lateral, or both — 'lower leg fasciotomy' without compartment identification is insufficient to support 27600 vs. 27601 vs. 27602.
Document compartment pressure measurements or clinical signs (tenseness, pain with passive stretch, neurovascular deficit) that established the indication for emergent or elective release.
Record whether wounds were closed primarily or left open for delayed/staged closure, and if staged, state the plan explicitly in the operative note.
Identify laterality (left vs. right leg) and apply modifier LT or RT; bilateral same-session cases require modifier 50.
For chronic exertional compartment syndrome, include pre-operative exertional pressure measurements or documented failure of conservative management.
Note any concomitant procedures (e.g., fracture fixation) and confirm they are documented at separate anatomic sites if unbundling modifiers are applied.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 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 27600 covers a fasciotomy limited to the anterior and/or lateral compartments of the lower leg. The fascia is incised to release pressure, most often in the setting of acute or chronic exertional compartment syndrome. When both posterior compartments also require release at the same operative session, step up to 27602. If only the posterior compartments are addressed, use 27601 instead — these three codes are mutually exclusive by anatomic compartment combination.

The 90-day global period means all routine follow-up through day 90 is bundled. Secondary wound closure or delayed primary closure performed within that window because the fasciotomy site was left open — a common practice — is reportable under modifier 58 (staged/related procedure), not modifier 78, because it was planned, not an unplanned return. Document the intent to stage closure in the original operative note.

Podiatry accounts for a significant share of 27600 volume in Medicare PUF data, but orthopedic surgeons and trauma surgeons perform this procedure frequently in both acute and chronic presentations. Acute compartment syndrome cases require clear documentation of measured compartment pressures or clinical criteria justifying emergent release; without that, payers routinely flag the claim for medical necessity review.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.88
Practice expense RVU	4.15
Malpractice RVU	1.22
Total RVU	11.25
Medicare national rate	$375.76
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	$375.76
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 27600 get rejected.

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

Medical necessity denial when operative note lacks compartment pressure values or clinical criteria for compartment syndrome — payers expect objective data supporting the release.
Wrong code selected: billing 27600 when posterior compartments were also released; that scenario requires 27602, and auditors cross-reference operative note compartment descriptions.
Modifier missing or wrong when a staged wound closure is billed in the global period — using modifier 78 instead of 58 on a planned delayed closure triggers rejection.
Laterality modifier absent (LT/RT) causing claim rejection from payers that require anatomic side designation on unilateral lower extremity codes.
Unbundling of local anesthesia injection reported separately — per NCCI policy, local anesthesia for the surgical field is not separately reportable alongside the fasciotomy code.

Frequently asked questions

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

01What is the difference between 27600, 27601, and 27602?

27600 = anterior and/or lateral compartments only. 27601 = posterior compartment(s) only. 27602 = anterior and/or lateral plus posterior compartments. Select the code that matches exactly which compartments are documented as released in the operative note. Do not bill more than one of these three codes for the same leg at the same session.

02Can I bill staged wound closure during the 90-day global period?

Yes, with modifier 58. Delayed primary or secondary closure of a fasciotomy wound that was intentionally left open is a staged related procedure. Use modifier 58 on the closure code. Modifier 78 applies only to unplanned returns to the OR for a related complication — do not use it for planned staged closure.

03Is modifier 50 correct if I decompress both legs in the same session?

Yes. Bilateral same-session fasciotomies use modifier 50 on a single line. Some payers prefer two lines with LT and RT instead — verify payer preference before submitting, as Medicare and commercial payers differ on this.

04What ICD-10 diagnoses support 27600 for medical necessity?

Acute traumatic compartment syndrome of the lower leg (M79.A21/M79.A22) and chronic exertional compartment syndrome are the primary diagnoses. Post-traumatic or post-surgical presentations should reflect the underlying injury or procedure. Payers will deny claims where the diagnosis doesn't align with the clinical scenario described in the note.

05Can 27600 be billed same-day with a fracture fixation code?

Yes, when the fasciotomy is performed as a separate procedure at a clinically distinct indication from the fracture repair — for example, acute compartment syndrome following tibial shaft fracture fixation. Append modifier 59 or XS to 27600 to indicate it is a distinct procedure. The operative note must describe separate incisions or separate indications.

06Does 27600 require prior authorization?

For emergent acute compartment syndrome, prior authorization is typically not feasible and payers generally recognize that. For elective chronic exertional compartment syndrome cases, many commercial payers and some Medicaid managed care plans require prior authorization — check payer-specific requirements before scheduling elective fasciotomies.

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 specific compartments released (anterior, lateral, posterior), whether wounds were closed or left open for staged closure, and any intraoperative compartment pressure measurements from dictation. This directly determines whether 27600, 27601, or 27602 is correct and eliminates the most common audit flag — operative notes that name the incision site without specifying which compartments were decompressed.

See how Mira captures CPT 27600 documentation