Radical resection of a soft-tissue tumor (e.g., sarcoma) in the leg or ankle region, with the tumor and its margins measuring less than 5 cm.

Verified May 8, 2026 · 7 sources ↓

Medicare: $942.91
Total RVUs: 28.23
Global, days: 90
Region: Foot & ankle

Drawn from CMSNIHFindacodeAAPCCgsmedicare

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Operative note must state the oncologic intent of the resection and confirm wide margins were obtained, not just marginal or simple excision.
Specimen size documented in centimeters — tumor plus margins must measure less than 5 cm to support 27615 vs. 27616.
Depth of dissection clearly recorded — involvement of fascia distinguishes 27615 from subcutaneous-only code 27618 and integumentary codes.
Anatomic location specified as leg (tibia/fibula region) or ankle; generic 'lower extremity' language is insufficient for site-specific audit defense.
Pathology report correlating with operative findings is expected for any radical resection billed with a malignant or suspected-malignant diagnosis.
If bilateral resections are performed, laterality (LT/RT) must be documented for each site.

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 51 Multiple procedures 58 Staged or related 59 Distinct service 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 ↓

CPT 27615 covers wide, oncologic-margin resection of soft-tissue tumors suspected to be malignant — classically sarcoma — located in the leg (tibia/fibula region) or ankle, where the combined tumor-plus-margin specimen is under 5 cm. The procedure requires excision of surrounding tissue beyond the lesion itself; simple or marginal excisions of benign soft-tissue masses do not meet this code's threshold. When the resected specimen measures 5 cm or greater, step up to CPT 27616.

The code sits in the musculoskeletal excision section, not the integumentary section. That distinction matters when the tumor extends to or involves the fascia — operative notes documenting depth and margin adequacy are what justify 27615 over skin-section codes (e.g., 11640 series) or the subcutaneous-only code 27618. Depth of dissection and the oncologic intent of the resection are the defining documentation factors.

The 90-day global period applies. All routine post-op visits, wound checks, and dressing changes through day 90 are bundled. Unrelated procedures or evaluation of new problems during that window require modifier 24 or 25 on the associated E/M. The code is performed almost exclusively in an on-campus outpatient hospital or ASC setting; site of service affects payment significantly (see the Site of Service comparison table).

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	15.33
Practice expense RVU	9.61
Malpractice RVU	3.29
Total RVU	28.23
Medicare national rate	$942.91
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	$942.91
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 27615 get rejected.

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

Upcoding flag: payer downcodes to 27618 (subcutaneous excision) or 27630 (lesion of tendon sheath) when operative note lacks explicit fascial depth or margin documentation.
Size mismatch: specimen pathology report records a diameter ≥5 cm, triggering denial or recoupment in favor of 27616.
Wrong code family: billing 11640 (integumentary wide excision) instead of 27615 when dissection clearly extended to or through the fascia.
Global period conflict: E/M billed within the 90-day global without modifier 24 or 25, denied as bundled post-op care.
Missing malignant or suspected-malignant diagnosis linkage — payers require an ICD-10 code consistent with sarcoma or malignant neoplasm to support radical resection intent.

Frequently asked questions

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

01What separates 27615 from 27618?

27618 covers excision of a benign or subcutaneous soft-tissue tumor in the leg/ankle. 27615 requires oncologic (radical) intent with wide margins and typically involves dissection at or through the fascial layer. If the operative note documents dissection only above the fascia with no oncologic margin requirement, 27618 is the correct code.

02When do I use 27616 instead of 27615?

Use 27616 when the resected specimen — tumor plus surgical margins — measures 5 cm or greater. The size threshold is based on the excised specimen, not the imaging-measured tumor alone. Confirm against the pathology report before coding.

03Can 27615 be billed with a skin-section wide-excision code like 11640 on the same day?

Generally no. If the resection extends to the fascia, 27615 is the correct code and subsumes the skin incision. Billing both creates a bundling conflict. Use 27615 alone when fascial depth is documented; use 11640-series only when the excision is confined to skin and subcutaneous tissue without fascial involvement.

04What modifiers are needed when operating on both legs on the same date?

Append LT and RT to distinguish the two sites. Also append modifier 51 (multiple procedures) to the lower-valued procedure if both are performed under the same anesthetic. Document separate tumor locations, sizes, and margins for each side in the operative note.

05How does the 90-day global period affect follow-up oncology visits?

Routine post-op visits within 90 days are bundled. If a follow-up visit addresses a new or unrelated problem — for example, a chemotherapy complication or a separate diagnosis — append modifier 24 to the E/M code to bypass the global and document the unrelated nature clearly in the note.

06Is modifier 22 ever appropriate for 27615?

Yes, when the procedure is substantially more complex than typical — for example, tumor involving major neurovascular structures requiring neurolysis, or requiring reconstruction not captured by a separate code. Document the additional work explicitly in the operative note; a blanket 'difficult case' statement will not survive audit.

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 surgeon's dictation for tumor location (leg vs. ankle), specimen size in centimeters including margins, depth of dissection relative to fascia, and oncologic resection intent. This prevents the two most common downcodes: a payer dropping 27615 to 27618 because fascial depth was never stated, or a recoupment triggered by a pathology-reported size that contradicts the operative note.

See how Mira captures CPT 27615 documentation