Surgical removal of a subcutaneous soft tissue tumor measuring 3 cm or greater from the leg or ankle area, not involving deep fascial layers.

Verified May 8, 2026 · 7 sources ↓

Medicare: $393.13
Work RVU: 5.76
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeMdclarityAbos

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Measured lesion size (3 cm or greater) documented in the operative report — payers audit size thresholds that determine code selection between 27618 and 27632
Confirmation that the tumor is subcutaneous (above the deep fascia) — depth determines whether 27632, 27619, or 27634 applies
Laterality (left vs. right leg/ankle) clearly stated in the operative note and on the claim
Pre-operative imaging or biopsy results supporting medical necessity, especially if malignancy was suspected
Pathology submission documentation and specimen labeling to support separately billed pathology codes
Description of anatomic location within the leg or ankle region to support ICD-10 diagnosis code specificity

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 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 ↓

27632 covers excision of a subcutaneous tumor in the leg or ankle region when the lesion measures 3 cm or greater in diameter. The tumor sits above the deep fascia — if the lesion is intramuscular or subfascial, look to 27619 (deep, under 5 cm) or 27634 (deep, 5 cm or greater). Lesions under 3 cm fall under 27618. Size is measured at the lesion itself, not the excision margin.

The 90-day global period covers the operative session and all routine post-op care through day 90. Any E/M visit unrelated to the excision during that window requires modifier 24. A planned staged procedure in the global period uses modifier 58; an unplanned return to the OR for a related complication uses modifier 78.

Pathology is not bundled into 27632 — bill the appropriate pathology code separately. Pre-operative imaging (MRI or ultrasound used to characterize the lesion) is also separately reportable if performed and documented as a distinct medical necessity. Confirm laterality with modifier LT or RT; payers increasingly hard-edit laterality on extremity 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 vs. total RVU

The work RVU (5.76) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.77) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.76
Practice expense RVU	4.79
Malpractice RVU	1.22
Total RVU	11.77
Medicare national rate	$393.13
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	$393.13
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 27632 get rejected.

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

Wrong code selected due to failure to confirm tumor depth — subcutaneous vs. deep is the most frequent 27632/27619 mismatch
Lesion size not documented in the operative report, triggering medical necessity denial or downcode to 27618
Missing or inconsistent laterality — payers flag claims without LT or RT modifier on unilateral extremity procedures
ICD-10 diagnosis code does not support surgical excision (e.g., unspecified neoplasm code without imaging or prior biopsy documentation)
Post-op E/M billed without modifier 24 during the 90-day global period, resulting in automatic bundling denial

Frequently asked questions

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

01What separates 27632 from 27618?

Size. 27618 is for subcutaneous leg or ankle tumors under 3 cm; 27632 is for those measuring 3 cm or greater. The depth classification is the same — both are subcutaneous. Document the measured lesion size explicitly in the operative note.

02When should I use 27619 or 27634 instead of 27632?

Use 27619 when the tumor is deep to the fascia and under 5 cm; use 27634 when it is deep and 5 cm or greater. 27632 is strictly subcutaneous. If your operative note confirms the tumor was subfascial or intramuscular, 27632 is the wrong code regardless of size.

03Can I bill pathology separately with 27632?

Yes. Pathology is not bundled into 27632. Submit the appropriate surgical pathology code (88302–88309 based on specimen type and complexity) separately. Ensure the operative note documents specimen submission.

04How does the 90-day global period affect billing for post-op complications?

Routine post-op visits are bundled through day 90. If the patient returns to the OR for a complication related to the excision — such as wound dehiscence requiring reoperation — use modifier 78. If the return procedure is for an entirely unrelated condition, use modifier 79.

05Is modifier 50 appropriate if tumors are excised from both legs in the same session?

Yes, modifier 50 applies if truly bilateral lesions are excised in the same operative session. Alternatively, use LT and RT on separate line items — some payers require the two-line approach over modifier 50. Confirm your payer's preference before submitting.

06Do I need modifier 59 when billing 27632 alongside a different leg or ankle procedure on the same day?

Check the NCCI procedure-to-procedure (PTP) edits for the specific code pair. If an edit exists with modifier indicator '1', append modifier 59 (or an X modifier if the payer requires it) to document that the procedures are distinct. Do not use 59 reflexively — it must reflect a genuinely separate service.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures lesion size in centimeters, anatomic location, tissue depth (subcutaneous vs. subfascial), and laterality directly from the surgeon's dictation. It flags operative notes that omit a numeric size measurement or describe depth as 'superficial' without specifying the fascial relationship — the two documentation gaps most likely to trigger a payer downcode from 27632 to 27618 or a denial for unspecified depth.

See how Mira captures CPT 27632 documentation