Decompression fasciotomy of the lower leg addressing both anterior/lateral and posterior compartments via surgical release of fascial coverings.

Verified May 8, 2026 · 7 sources ↓

Medicare: $443.90
Work RVU: 7.62
Global, days: 90
Region: Foot & ankle

Drawn from CMSAbosAAPCNIHFindacode

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Explicit identification of all compartments released (anterior, lateral, deep posterior, superficial posterior) with intraoperative compartment pressure measurements if obtained
Clinical indication documented by name — acute compartment syndrome, post-ischemic reperfusion, crush injury, etc. — not just 'swelling' or 'pressure'
Confirmation that wounds were left open at conclusion of procedure, with plan for staged closure
Laterality (left vs. right leg) stated in both the preoperative diagnosis and the operative report body
If concurrent vascular or orthopedic procedures were performed, documentation of distinct surgical steps for each separately coded service
Neurovascular status of the limb documented pre- and post-decompression to support medical necessity

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 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 7 cited references ↓

27602 covers a fasciotomy that releases all compartments of the lower leg — anterior, lateral, and posterior — in a single operative setting. This is the most extensive of the leg fasciotomy codes (27600–27602), distinguished from 27600 (anterior/lateral only) and 27601 (posterior only) by the combined compartment release. It is most commonly performed for acute compartment syndrome, whether traumatic, post-ischemic, or associated with vascular injury requiring concurrent revascularization.

The 90-day global period means all routine post-op management through day 90 is bundled. Fasciotomy wounds are intentionally left open; the initial decompression does not include delayed closure. When the surgeon returns in a planned staged fashion to close the wounds, bill 13160 (or the appropriate repair code) with modifier 58. Simple and intermediate closures performed at the same operative session are bundled into 27602 and cannot be separately reported. Complex closure at the same session may be separately billable — verify NCCI edits before appending.

When 27602 is performed alongside vascular procedures (e.g., embolectomy, stent placement), each distinct procedure requires its own code with modifier 59 or an X-modifier to document the separate service. Bilateral leg fasciotomy — uncommon but seen in crush injury — bills with modifier 50.

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 (7.62) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (13.29) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.62
Practice expense RVU	3.79
Malpractice RVU	1.88
Total RVU	13.29
Medicare national rate	$443.90
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	$443.90
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 27602 get rejected.

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

Upcoding flag when operative note describes only anterior/lateral release but 27602 (all compartments) is billed — auditors compare code to documented compartments
Missing laterality modifier (LT or RT) triggering edit or manual review by payer
Staged wound closure billed without modifier 58 during the global period, resulting in global period bundling denial
Lack of documented compartment syndrome diagnosis or absence of clinical indicators (pain with passive stretch, firmness, neurovascular compromise) undermining medical necessity
Simple or intermediate fasciotomy closure billed as a separate line item on the same date of service — bundled per NCCI policy

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

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

27600 covers anterior and/or lateral compartments only. 27601 covers posterior compartment(s) only. 27602 is the all-compartments code — anterior, lateral, and posterior released in the same operative session. Bill the code that matches what was actually released; upcoding to 27602 when only one compartment group was entered is an audit target.

02Can the fasciotomy wound closure be billed separately?

Yes, but timing matters. Closure at the same operative session is bundled for simple and intermediate repairs. Complex closure at the same session may be separately reportable — check NCCI edits. Delayed closure on a subsequent date during the global period bills with modifier 58 (staged procedure). CPT 13160 is commonly cited for secondary wound closure in this context.

03How should I bill 27602 when the surgeon also performed a vascular procedure like embolectomy on the same day?

Bill each procedure with its own code and append modifier 59 (or an X-modifier) to the secondary code to document it as a distinct service. The operative note must describe separate surgical steps for each procedure. AAPC forum precedent shows 27602 paired with codes such as 37228 and 34201 in combined vascular/fasciotomy cases.

04Does bilateral leg fasciotomy bill with modifier 50?

Yes. If both legs undergo all-compartment fasciotomy in the same session, bill 27602 with modifier 50. Alternatively, bill two lines with LT and RT. Confirm bilateral policy with the specific payer — some prefer two line items over modifier 50.

05What is the global period for 27602 and what does it include?

27602 carries a 90-day global period. That covers the surgery day, the day-before pre-op visit, and all routine post-op care through day 90. Unrelated procedures in the global window need modifier 79. A return to the OR for a related complication (e.g., debridement of nonviable muscle) needs modifier 78. Planned staged closure needs modifier 58.

06Can I report debridement of nonviable muscle separately if performed at a second-stage procedure after the initial fasciotomy?

Yes. A return to the OR two or more days after the initial fasciotomy for debridement of nonviable muscle and nerve is a separately reportable service. Bill the appropriate debridement code with modifier 78 if the return is related to the original procedure and the patient is still in the global period. Document the distinct findings and operative steps clearly.

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 entered and released, the wound management plan (open vs. closure), and laterality directly from dictation. It flags operative notes that reference only one compartment group when 27602 is selected, preventing the most common audit trigger for this code. If a concurrent vascular procedure is dictated, the scribe surfaces a prompt to confirm distinct procedural documentation for modifier 59 support.

See how Mira captures CPT 27602 documentation