Decompression fasciotomy of the leg covering anterior and/or lateral compartments plus posterior compartment(s), with removal of nonviable muscle and/or nerve tissue.

Verified May 8, 2026 · 6 sources ↓

Medicare: $757.20
Work RVU: 12.35
Global, days: 90
Region: Foot & ankle

Drawn from CMSFastrvuAbosAAPCGenhealth

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Identify each compartment decompressed by name — anterior, lateral, and/or posterior — with explicit statement that all targeted compartment groups were addressed
Document the presence and extent of nonviable muscle and/or nerve tissue, and confirm debridement was performed
Record the clinical indication for fasciotomy, including compartment pressure measurements or clinical findings consistent with acute compartment syndrome
Describe incision placement, length, and approach for each compartment entered
Note wound status at closure — whether wounds were left open, partially closed, or closed with grafts — to support staged-procedure billing if applicable
If bilateral fasciotomies performed, document each side separately and append modifier 50 or LT/RT as appropriate

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 52 Reduced services 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 6 cited references ↓

27894 is the highest-complexity code in the leg fasciotomy family (27892–27894). It requires decompression of both the anterior and/or lateral compartments AND the posterior compartment(s), combined with debridement of nonviable muscle and/or nerve. Use it only when all targeted compartment groups are addressed with debridement in the same operative session — not when debridement is absent (that's 27602) or when only one compartment group is treated.

The code carries a 90-day global period. Any return to the OR for wound management, skin grafting, or further debridement within that window must be appended with the appropriate modifier — modifier 78 if the return procedure is related to the original fasciotomy (e.g., wound complications), modifier 79 if unrelated. Staged debridement performed through already-open wounds without new incisions should be billed using wound debridement codes (110xx series) rather than a repeat 27894.

Site of service matters significantly here. HOPD and ASC payments differ substantially — see the site-of-service comparison table. The procedure is performed in a hospital OR setting given the severity of compartment syndrome; ASC billing is uncommon but technically available. Always confirm the operative note names each compartment entered and explicitly documents the debridement of nonviable tissue — those two elements are what separate 27894 from its lower-complexity siblings.

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 (12.35) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (22.67) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	12.35
Practice expense RVU	7.53
Malpractice RVU	2.79
Total RVU	22.67
Medicare national rate	$757.20
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	$757.20
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 27894 get rejected.

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

Operative note fails to document debridement of nonviable tissue, making 27894 unsupported over the lower-level 27602
Only one compartment group addressed but 27894 billed — posterior-only maps to 27893, anterior/lateral-only maps to 27892
Staged second-look debridement through open wounds billed as repeat 27894 instead of wound debridement (110xx series)
Missing modifier 78 or 79 on a return-to-OR procedure within the 90-day global period, resulting in global period bundling denial
Diagnosis code does not support acute compartment syndrome or fails to lateralize to the operative extremity

Frequently asked questions

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

01What separates 27894 from 27892 and 27893?

All three require debridement of nonviable muscle and/or nerve. 27892 covers anterior and/or lateral compartments only. 27893 covers posterior compartment(s) only. 27894 requires both compartment groups to be decompressed with debridement in the same session. If only one group is treated, use the lower-level code.

02Can I bill 27894 when the surgeon returns to debride through already-open wounds?

No. When no new fasciotomy incisions are made and the surgeon is only debriding through existing open wounds, bill wound debridement codes in the 110xx series based on the documented wound surface area. Appending modifier 52 to 27894 is not the correct approach here.

03What modifier applies to a return to the OR for wound closure or skin grafting within the 90-day global?

Use modifier 78 — unplanned return to the OR for a procedure related to the original fasciotomy. Skin grafting over a fasciotomy wound is a textbook modifier 78 scenario. Modifier 79 is reserved for an unrelated procedure during the same global period.

04Is 27894 billable at an ASC?

Technically yes — ASC payment exists under the 2026 fee schedule. In practice, acute compartment syndrome requiring 27894 almost always presents in a hospital OR. If you are billing ASC, confirm the facility's ASC-covered procedure list, as some payers exclude high-acuity fasciotomies from ASC reimbursement.

05When is modifier 22 appropriate with 27894?

Append modifier 22 when the procedure is substantially more complex than typical — for example, massively necrotic tissue requiring extensive multilevel debridement, or reoperative anatomy from prior surgeries that significantly increases intraoperative time and complexity. Document the increased time and specific complicating factors in the operative note; without that, modifier 22 will be denied.

06Can 27892, 27893, and 27894 all be billed together if multiple compartment groups are treated?

No. 27894 is the inclusive code when both anterior/lateral and posterior compartments are decompressed with debridement. Billing 27892 or 27893 alongside 27894 for the same extremity in the same session would result in NCCI bundling edits. Use 27894 alone.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures each compartment entered by name, the surgeon's intraoperative description of nonviable tissue, and confirmation that debridement was performed — the three documentation elements auditors check first on 27894. It also flags when the dictation describes only open-wound debridement without new incisions, prompting the coder to evaluate wound debridement codes instead of a repeat fasciotomy code. This prevents both downcoding denials and incorrect repeat-procedure billing.

See how Mira captures CPT 27894 documentation