CPT 27048 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

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

CPT code 27048 denotes the surgical excision of a subfascial soft-tissue tumor in the pelvis or hip with a lesion size under 5 centimeters. This code captures a focused oncologic or general surgical intervention performed in the deep soft tissues beneath the fascial layer and is used in billing for operating-room or ambulatory surgical center services. Nationally, accurate coding of these procedures affects procedure-level utilization counts, complication tracking, and payment for surgical oncology and orthopedics.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code is defined and when it applies clinically, typical service settings, common modifiers used with this procedure, and payer relevance for coverage and claims processing. The publication also outlines benchmark considerations and policy items relevant to billing and classification of subfascial pelvic/hip soft-tissue tumor excisions. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27048soft tissue tumor excisionpelvis hip surgerysurgical oncologyambulatory surgical centeroperative reportingprocedure codingsubfascial excision

Billing Code Overview

CPT code 27048 describes the surgical excision of a soft tissue tumor located in the pelvis or hip region at the subfascial level, with a specimen size of less than 5 centimeters. This procedure involves removal of a discrete neoplasm from the deep soft tissues beneath the fascial plane in the pelvic/hip soft-tissue compartment.

Service type: Surgical excision of soft tissue tumor (subfascial), < 5 cm
Typical site of service: Operating room or ambulatory surgical center for pelvic/hip soft-tissue tumor resection

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient presents with a palpable, painful soft-tissue mass in the lateral hip region. Imaging with MRI demonstrates a well-circumscribed, likely benign soft-tissue neoplasm located deep to the fascia (subfascial) measuring 3.2 cm in greatest dimension. The surgical plan is an excision of the mass under general anesthesia with peripheral nerve and vascular structures identified and protected. The patient receives preoperative evaluation in the ambulatory surgery center; intraoperative steps include localization, incision overlying the lesion, dissection through subcutaneous tissue to the fascia, careful blunt and sharp dissection beneath the fascia to isolate the tumor, tumor removal with appropriate margins less than 5 cm, hemostasis, irrigation, and layered closure. Postoperative workflow includes recovery in the PACU, wound care instructions, pathology submission of the specimen, and a postoperative clinic follow-up visit to assess wound healing and review pathology results.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral Procedure	Use when the same excision is performed on both the left and right pelvic/hip soft tissue sites during the same operative session.
`51`

CPT 27059: Extensive Pelvis/Hip Soft Tissue Tumor Resection, 5 cm or Larger

CPT-27066-EXCISION-BENIGN-BONE-LESION-ILIUM-TROCHANTER

CPT 27066: Excision of Deep Bone Cyst or Benign Tumor with Reconstruction

CPT-27078-RADICAL-RESECTION-ISCHIAL-TUBEROSITY-GREATER-TROCHANTER

CPT 27078: Radical Resection of Ischial Tuberosity and Greater Trochanter

CPT-27060-ISCHIAL-BURSA-EXCISION

CPT 27060: Excision of Ischial Bursa

CPT-27040-PELVIC-HIP-SUPERFICIAL-SOFT-TISSUE-BIOPSY

CPT 27040: Superficial Soft Tissue Biopsy of Pelvis and Hip

CPT-27075-RADICAL-RESECTION-PELVIC-BONE-TUMOR

CPT 27075: Radical Resection of Pelvic Bone Tumor

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-27054-OPEN-HIP-SYNOVECTOMY

CPT 27054: Open Synovectomy of Hip

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

CPT 27052: Open Biopsy of Hip Soft Tissue

CPT-27080-COCCYGECTOMY-REMOVAL-OF-TAIL-BONE

CPT 27080: Coccygectomy, Removal of Coccyx

Showing 1–10 of 23

Taxonomy Code	Specialty	Notes
2080P0200X	Orthopedic Surgery	Orthopedic surgeons commonly excise deep soft-tissue tumors of the pelvis/hip.
207K00000X	General Surgery	General surgeons perform soft-tissue tumor excisions in the pelvis/hip region, especially in community settings.
207L00000X	Surgical Oncology	Surgical oncologists manage excisions when malignancy is suspected or confirmed.
208000000X	Plastic Surgery	Plastic surgeons may perform excision with reconstruction when complex closure or flap is needed.
2084P0800X	Vascular Surgery	Vascular surgeons may be involved if lesion abuts or involves major pelvic vessels.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M89.0`	Data not available in the input.	Data not available in the input.
`D48.2`	Data not available in the input.	Data not available in the input.
`C49.A9`	Data not available in the input.	Data not available in the input.
`M79.2`	Data not available in the input.	Data not available in the input.
`R22.2`	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27047`	Excision, tumor, soft tissue of pelvis and hip area; subcutaneous (superficial), less than 5 cm	Performed for more superficial lesions located above the fascia; may be an alternative when the tumor is subcutaneous rather than subfascial.
`27049`	Excision, tumor, soft tissue of pelvis and hip area; any location, 5 cm or greater	Used when the tumor measures 5 cm or greater; represents the next size-based code for larger lesions.
`11042`	Debridement; subcutaneous tissue (includes epidermis and dermis when performed), first 20 sq cm or less — simple or intermediate	May be reported if significant debridement of subcutaneous tissue is required in addition to tumor excision.
`20610`	Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee); without ultrasound guidance	May be performed preoperatively for diagnostic aspiration if the lesion communicates with a fluid collection or bursa.
`88305`	Surgical pathology, gross and microscopic examination, tissue exam	Used for pathology processing and reporting of the excised tumor specimen; typically billed by pathology services.

OpenPayer