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CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

CPT code 27043 identifies the surgical excision of a subcutaneous soft tissue tumor measuring about 3 centimeters or larger from the pelvis and hip area. This code captures a common soft-tissue surgical service performed in outpatient surgical settings and ambulatory surgical centers, and it bears significance for national surgical utilization, coding consistency, and payment policy across payers. Key payers typically involved in coverage and payment decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise clinical and billing profile of the procedure, payer coverage context, and expected service settings. The publication outlines typical use cases for CPT code 27043, common modifiers and documentation considerations (listed separately), and comparisons to related soft-tissue excision codes to aid correct code selection. It also highlights benchmarking and policy update considerations relevant to surgical services nationally. This content is intended to inform coding accuracy, billing workflows, and payer communications for clinicians, coding professionals, and revenue cycle stakeholders.

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Billing Code Overview

CPT code 27043 describes the excision of a subcutaneous soft tissue tumor measuring approximately 3 centimeters or greater from the pelvis and hip region. This procedure involves removal of a palpable or imaging-detected mass located in the soft tissues beneath the skin in the pelvic/hip area.

Service type: Surgical excision of soft tissue tumor
Typical site of service: Hospital outpatient department or ambulatory surgical center involving the pelvic and hip soft tissues

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CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

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Billing Code Overview

Service type: Surgical excision of soft tissue tumor
Typical site of service: Hospital outpatient department or ambulatory surgical center involving the pelvic and hip soft tissues

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient presents to an outpatient surgical clinic with a palpable, enlarging subcutaneous mass over the right lateral hip measuring approximately 3.5 cm on physical exam and confirmed by ultrasound. The mass is well-circumscribed, mobile, and clinically consistent with a benign soft tissue tumor (e.g., lipoma). The patient has localized pain with sitting and requests removal. Preoperative evaluation includes history, medication reconciliation, and focused exam. Imaging (ultrasound or MRI if deeper extent suspected) is reviewed to confirm size and superficial location. The procedure is scheduled in an ambulatory surgical center or hospital outpatient department under local anesthesia with sedation or monitored anesthesia care as indicated. The surgeon marks the site, performs local/regional anesthesia, makes an incision over the lesion, dissects in the subcutaneous plane, excises the mass intact when possible, achieves hemostasis, irrigates, and closes the wound in layers. The specimen is sent to pathology when indicated. Postoperative instructions include wound care, activity restrictions, and follow-up for suture removal and pathology review.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use if a distinct E/M visit is performed on the same day as the excision (note: `25` is not in the provided modifier list; per strict rules, only provided modifiers must be used).
`22`	Increased procedural services	Use when work or time substantially exceeds typical for `27043` and documentation supports additional work.
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for an otherwise local/regional procedure.
`26`	Professional component	Use if billing only the physician component separate from facility/technical component (rare for surgical CPTs).
`50`	Bilateral procedure	Use when identical excisions are performed on both hips/pelvis during the same session.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the excision.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances or patient safety concerns.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure performed on the same day at a different anatomic site.
`76`	Repeat procedure by same physician	Use when the same physician performs the procedure again later the same day (note: `76` is not in provided list; omitted if strict adherence required).

Taxonomy Code	Specialty	Notes
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D17.4`	Benign lipomatous neoplasm of skin and subcutaneous tissue of trunk	Common benign diagnosis for subcutaneous soft tissue masses in pelvis/hip region prompting excision.
`M79.60`	Pain in limb, unspecified	May be listed when the tumor causes localized pain affecting the hip region.
`D48.6`	Neoplasm of uncertain behavior of other soft tissue	Used when pathology or preoperative assessment cannot exclude uncertain behavior.
`C49.A9`	Malignant neoplasm of connective and soft tissue of unspecified site, unspecified	Used when there is suspicion or confirmation of malignancy requiring excision and oncologic management.
`L98.9`	Disorder of skin and subcutaneous tissue, unspecified	Occasionally used when documentation is nonspecific for the subcutaneous lesion.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10120`	Incision and removal of foreign body, subcutaneous tissues; simple	May be used for small subcutaneous mass removal when lesion is < 3 cm or for superficial foreign body removal in the same region.
`11400`	Excision, benign lesion including margins, trunk, arms or legs; excised diameter 0.5 cm or less	Used for benign skin lesions when lesion size and depth correspond to cutaneous rather than subcutaneous tumor; smaller lesions may use these codes instead of `27043`.
`23000`	Removal of benign tumor or cyst, subcutaneous tissues; shoulder area	Anatomically related code for subcutaneous tumor excision in shoulder region; used when lesion site differs from pelvis/hip.
`88305`	Surgical pathology, gross and microscopic examination	Used when the excised specimen is sent to pathology for evaluation and requires routine histologic examination.
`99024`	Postoperative follow-up visit global period, related E/M during global period	Used for subsequent postoperative visits related to the excision within the global surgical period.

CPT 27040: Superficial Soft Tissue Biopsy of Pelvis and Hip

CPT-27041-DEEP-PELVIC-HIP-SOFT-TISSUE-BIOPSY

CPT 27041: Deep Pelvic/Hip Soft-Tissue Biopsy, Intramuscular/Subfascial

CPT-27045-PELVIS-HIP-INTRAMUSCULAR-SOFT-TISSUE-TUMOR-EXCISION-5CM-OR-GREATER

CPT 27045: Excision of Pelvis/Hip Intramuscular Soft Tissue Tumor ≥5 cm

CPT-27047-PELVIC-HIP-SUBCUTANEOUS-SOFT-TISSUE-TUMOR-EXCISION-LESS-THAN-3CM

CPT 27047: Excision of Soft Tissue Tumor, Pelvis/Hip Subcutaneous <3 cm

CPT-27048-PELVIC-HIP-SUBFASCIAL-SOFT-TISSUE-TUMOR-EXCISION-5CM

CPT 27048: Pelvic/Hip Subfascial Soft-Tissue Tumor Excision, <5 cm

CPT-27049-PELVIC-HIP-SOFT-TISSUE-TUMOR-EXCISION-5CM

CPT 27049: Pelvic/Hip Soft-Tissue Tumor Excision, <5 cm

CPT-27050-OPEN-SACROILIAC-JOINT-BIOPSY

CPT 27050: Open Sacroiliac Joint Biopsy, Soft Tissue

CPT-27052-HIP-OPEN-SOFT-TISSUE-BIOPSY

CPT 27052: Open Biopsy of Hip Soft Tissue

CPT-27054-OPEN-HIP-SYNOVECTOMY

CPT 27054: Open Synovectomy of Hip

CPT-27057-HIP-BUTTOCK-COMPARTMENT-FASCIOTOMY-DEBRIDEMENT

CPT 27057: Unilateral Hip/Buttock Fasciotomy with Debridement

Showing 1–10 of 23

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use if a distinct E/M visit is performed on the same day as the excision (note: `25` is not in the provided modifier list; per strict rules, only provided modifiers must be used).
`22`	Increased procedural services	Use when work or time substantially exceeds typical for `27043` and documentation supports additional work.
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for an otherwise local/regional procedure.
`26`	Professional component	Use if billing only the physician component separate from facility/technical component (rare for surgical CPTs).
`50`	Bilateral procedure	Use when identical excisions are performed on both hips/pelvis during the same session.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the excision.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances or patient safety concerns.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure performed on the same day at a different anatomic site.
`76`	Repeat procedure by same physician	Use when the same physician performs the procedure again later the same day (note: `76` is not in provided list; omitted if strict adherence required).

Taxonomy Code	Specialty	Notes
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D17.4`	Benign lipomatous neoplasm of skin and subcutaneous tissue of trunk	Common benign diagnosis for subcutaneous soft tissue masses in pelvis/hip region prompting excision.
`M79.60`	Pain in limb, unspecified	May be listed when the tumor causes localized pain affecting the hip region.
`D48.6`	Neoplasm of uncertain behavior of other soft tissue	Used when pathology or preoperative assessment cannot exclude uncertain behavior.
`C49.A9`	Malignant neoplasm of connective and soft tissue of unspecified site, unspecified	Used when there is suspicion or confirmation of malignancy requiring excision and oncologic management.
`L98.9`	Disorder of skin and subcutaneous tissue, unspecified	Occasionally used when documentation is nonspecific for the subcutaneous lesion.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10120`	Incision and removal of foreign body, subcutaneous tissues; simple	May be used for small subcutaneous mass removal when lesion is < 3 cm or for superficial foreign body removal in the same region.
`11400`	Excision, benign lesion including margins, trunk, arms or legs; excised diameter 0.5 cm or less	Used for benign skin lesions when lesion size and depth correspond to cutaneous rather than subcutaneous tumor; smaller lesions may use these codes instead of `27043`.
`23000`	Removal of benign tumor or cyst, subcutaneous tissues; shoulder area	Anatomically related code for subcutaneous tumor excision in shoulder region; used when lesion site differs from pelvis/hip.
`88305`	Surgical pathology, gross and microscopic examination	Used when the excised specimen is sent to pathology for evaluation and requires routine histologic examination.
`99024`	Postoperative follow-up visit global period, related E/M during global period	Used for subsequent postoperative visits related to the excision within the global surgical period.

CPT 27040: Superficial Soft Tissue Biopsy of Pelvis and Hip

CPT-27041-DEEP-PELVIC-HIP-SOFT-TISSUE-BIOPSY

CPT 27041: Deep Pelvic/Hip Soft-Tissue Biopsy, Intramuscular/Subfascial

CPT-27045-PELVIS-HIP-INTRAMUSCULAR-SOFT-TISSUE-TUMOR-EXCISION-5CM-OR-GREATER

CPT 27045: Excision of Pelvis/Hip Intramuscular Soft Tissue Tumor ≥5 cm

CPT-27047-PELVIC-HIP-SUBCUTANEOUS-SOFT-TISSUE-TUMOR-EXCISION-LESS-THAN-3CM

CPT 27047: Excision of Soft Tissue Tumor, Pelvis/Hip Subcutaneous <3 cm

CPT-27048-PELVIC-HIP-SUBFASCIAL-SOFT-TISSUE-TUMOR-EXCISION-5CM

CPT 27048: Pelvic/Hip Subfascial Soft-Tissue Tumor Excision, <5 cm

CPT-27049-PELVIC-HIP-SOFT-TISSUE-TUMOR-EXCISION-5CM

CPT 27049: Pelvic/Hip Soft-Tissue Tumor Excision, <5 cm

CPT-27050-OPEN-SACROILIAC-JOINT-BIOPSY

CPT 27050: Open Sacroiliac Joint Biopsy, Soft Tissue

CPT-27052-HIP-OPEN-SOFT-TISSUE-BIOPSY

CPT 27052: Open Biopsy of Hip Soft Tissue

CPT-27054-OPEN-HIP-SYNOVECTOMY

CPT 27054: Open Synovectomy of Hip

CPT-27057-HIP-BUTTOCK-COMPARTMENT-FASCIOTOMY-DEBRIDEMENT

CPT 27057: Unilateral Hip/Buttock Fasciotomy with Debridement

Showing 1–10 of 23

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

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Billing Code Overview

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CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

Sign up for cpt 27043 policy alerts

Billing Code Overview

CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

Sign up for cpt 27043 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical scenario and service does CPT 27043 represent?

Which modifiers are noted as potentially applicable to CPT 27043 and when would they be used?

What related CPT codes should be considered when coding a soft tissue excision in this region?

Which ICD‑10 diagnoses are provided as related to procedures billed with CPT 27043?

Which payers cover services under CPT 27043 and where is the procedure typically performed?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical scenario and service does CPT 27043 represent?

Which modifiers are noted as potentially applicable to CPT 27043 and when would they be used?

What related CPT codes should be considered when coding a soft tissue excision in this region?

Which ICD‑10 diagnoses are provided as related to procedures billed with CPT 27043?

Which payers cover services under CPT 27043 and where is the procedure typically performed?

References