Summary & Overview
CPT 27045: Excision of Pelvis/Hip Intramuscular Soft Tissue Tumor ≥5 cm
CPT code 27045 denotes surgical excision of a subfascial or intramuscular soft tissue tumor of 5 centimeters or greater in the pelvis and hip region. This code captures a higher-complexity, deep-tissue oncologic or benign tumor procedure that typically requires operative theater resources, intraoperative imaging or navigation in some cases, and multidisciplinary perioperative care. Nationally, accurate use of this code is important for procedure classification, surgical quality measurement, and appropriate resource allocation for complex soft tissue tumor management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and coding intent for deep pelvic and hip soft tissue tumor excisions, plus coverage and billing considerations relevant to major national payers. The publication also outlines benchmarks for service utilization, common billing modifiers and coding relationships, and policy or documentation factors that affect claim review and payment determinations. Data not available in the input for specific payor policies, associated taxonomies, ICD-10 diagnoses, and related codes is noted where relevant.
Billing Code Overview
CPT code 27045 describes the excision of a subfascial or intramuscular soft tissue tumor measuring 5 centimeters or greater from the pelvis and hip region. The service involves surgical removal of a deep-seated soft tissue mass located beneath the fascial plane or within muscle tissue.
-
Service type: Surgical excision of a large deep soft tissue tumor
-
Typical site of service: Operating room or ambulatory surgery center for pelvic and hip soft tissue tumor resection
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents with a progressively enlarging, deep-seated mass in the lateral hip/pelvic region. Imaging with MRI demonstrates a subfascial, intramuscular soft tissue tumor measuring 6.2 cm with concerning features for a soft tissue sarcoma. Core needle biopsy is performed preoperatively and returns a diagnosis consistent with a high-grade soft tissue neoplasm. The patient is scheduled for operative excision under general anesthesia. The surgical team plans a wide local excision of the tumor with appropriate oncologic margins, possible intraoperative frozen section, and layered closure. Perioperative workflow includes preoperative assessment, surgical consent specific to tumor excision, anesthesia evaluation, intraoperative specimen handling for pathology, and postoperative recovery with wound checks and follow-up for pathology results and adjuvant therapy planning. Typical sites of service for this procedure are an inpatient hospital operating room or an ambulatory surgical center when anesthesia and postoperative monitoring resources are available and the patient’s comorbidities permit same-day discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal (default) professional component | Use to indicate the usual level of service when no unusual circumstances are reported by the provider. |