Fasciotomy releasing pressure in the posterior compartment(s) of the lower leg to treat or prevent compartment syndrome.

Verified May 8, 2026 · 6 sources ↓

Medicare: $418.18
Work RVU: 5.9
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeGenhealthEmedny

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify compartment(s) released — posterior only for 27601; anterior/lateral involvement requires a different code
Document intracompartmental pressure measurements or detailed clinical findings (tense compartment, pain with passive stretch, paresthesias) justifying decompression
Operative note must name the surgical approach and describe the fascial incision(s) made, length, and anatomical boundaries released
Record whether the case is acute traumatic, acute-on-chronic, or chronic exertional compartment syndrome — payers use this to adjudicate medical necessity
Document pre-op neurovascular status (pulses, capillary refill, motor/sensory exam) and any post-op wound management plan
If bilateral, note that each limb was addressed separately and append modifier 50

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 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27601 covers a decompression fasciotomy limited to the posterior compartment(s) of the lower leg. The surgeon incises the fascia to relieve dangerously elevated intracompartmental pressure — a condition that, if untreated, causes muscle necrosis and permanent nerve damage. This is a distinct, limited procedure: if the anterior or lateral compartments are also released through separate incisions in the same operative session, a different code applies.

27601 carries a 90-day global period. All routine post-op care, wound checks, and dressing changes through day 90 are bundled. Unrelated E/M visits in that window need modifier 24; a separately identifiable same-day E/M needs modifier 25. The procedure is performed by both orthopedic surgeons and podiatrists — the latter billing predominantly in the outpatient setting.

Prior authorization is required by many commercial payers for elective decompression in chronic exertional compartment syndrome. Acute traumatic compartment syndrome typically bypasses that requirement, but the operative note must clearly document measured compartment pressures or clinical findings that support emergency intervention. Audit teams look for that specificity.

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 (5.9) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (12.52) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.9
Practice expense RVU	5.5
Malpractice RVU	1.12
Total RVU	12.52
Medicare national rate	$418.18
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	$418.18
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 27601 get rejected.

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

Medical necessity not supported — operative note lacks compartment pressure measurements or objective clinical findings
Wrong code selected when anterior or lateral compartments were also released in the same session
Missing prior authorization for elective (chronic exertional) cases with commercial or managed Medicaid payers
Global period conflict — post-op E/M billed without modifier 24 when service was unrelated, or modifier 24 applied to a clearly routine follow-up
Bilateral procedure billed on two claim lines without modifier 50, triggering duplicate-claim edits

Frequently asked questions

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

01What's the difference between 27601 and 27600?

27600 covers decompression of the anterior and/or lateral compartments only. 27601 is posterior compartment(s) only. If you released all four compartments in one session, neither code alone is correct — report the appropriate combination code or multiple codes per payer guidance.

02Can 27601 be billed bilaterally?

Yes. When both legs are decompressed at the same operative session, append modifier 50 to 27601 on a single claim line. Most payers reimburse at 150% of the single-leg rate. Do not submit two separate claim lines without modifier 50.

03Does acute traumatic compartment syndrome bypass prior authorization?

For most payers, yes — emergent decompression for acute traumatic compartment syndrome is not subject to prior authorization. Chronic exertional compartment syndrome treated electively almost always requires it. Document clearly which clinical scenario applies.

04What ICD-10 diagnoses support 27601?

The most accepted diagnoses are acute traumatic compartment syndrome of the lower leg (M79.A21/M79.A22 for right/left), post-procedural compartment syndrome, and chronic exertional compartment syndrome. The ICD-10 code must match the operative indication documented — mismatches are a leading claim rejection trigger.

05Is a same-day E/M billable with 27601?

Only if it is a separately identifiable service beyond the decision to operate. For elective cases where the E/M on the same day drove the surgical decision, use modifier 57. For a distinct E/M problem unrelated to the fasciotomy on the day of service, use modifier 25. Routine pre-op assessment is bundled.

06If I return to the OR within 90 days to manage a wound complication from the fasciotomy, what modifier do I use?

Modifier 78 — unplanned return to the OR for a complication related to the original procedure. Do not use modifier 79, which is reserved for a return to the OR for a completely unrelated procedure within the global period.

Sources & references

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

Mira Scribe

Mira's AI scribe captures compartment pressure values or documented clinical criteria from dictation, the specific compartment(s) released, incision approach and length, and pre/post neurovascular findings. That detail prevents the most common denial for 27601 — a note that confirms a fasciotomy happened but fails to establish why it was medically necessary or which compartments were addressed.

See how Mira captures CPT 27601 documentation