CPT 27075 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 27075: Radical Resection of Pelvic Bone Tumor

CPT code 27075 represents a radical surgical resection of a pelvic bone tumor involving the ilium wing, one pubic or ischial ramus, or the symphysis pubis. This oncologic procedure is performed to remove the tumor with a margin of healthy tissue and is nationally significant due to its complexity, potential impact on function, and implications for surgical oncology reimbursement and care coordination. Key payers covered in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 27075, typical sites of service, and the service type. The report summarizes payer coverage patterns and common billing modifiers used with this code, and it provides benchmarking information and policy considerations that affect payment and prior authorization practices. The content also outlines clinical considerations relevant to coding and claims submission for pelvic tumor resections. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27075pelvic tumor resectionorthopedic oncologysurgical oncologyhospital surgeryprocedure codingradical resectionbilling guidanceclaims processing

Billing Code Overview

CPT code 27075 describes a radical resection of a pelvic bone tumor involving a wing of the ilium, a single pubic or ischial ramus, or the symphysis pubis. The procedure entails excising the tumor along with several inches of surrounding healthy tissue to achieve clear margins.

Service type: Surgical oncology — radical tumor resection of the pelvis

Typical site of service: Hospital inpatient or outpatient surgical center, depending on clinical indications and the extent of resection.

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents with a progressively enlarging, painful mass involving the wing of the ilium identified on imaging and core needle biopsy as a primary bone sarcoma. Preoperative staging with CT chest and MRI pelvis shows a localized lesion without distant metastasis. The surgical oncology team plans a radical resection of the iliac wing with a rim of surrounding healthy tissue to obtain wide margins, control local disease, and allow for reconstruction as needed. The procedure is performed in an inpatient operating room under general anesthesia by an orthopedic oncologist with assistance from a reconstructive surgeon when pelvic stability or soft-tissue coverage requires it. Typical perioperative workflow includes preoperative consent with discussion of risks (bleeding, infection, neurovascular injury, need for reconstruction), marking of laterality, administration of prophylactic antibiotics, intraoperative tumor excision with margin assessment by frozen section as indicated, hemostasis, and immediate reconstruction or stabilization. Postoperatively the patient is admitted for pain control, wound monitoring, thromboprophylaxis, and physical therapy with follow-up imaging and pathology review to guide any adjuvant oncologic therapies.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or intensity substantially exceeds typical for the procedure (document specifics).

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

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

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

CPT-27059-EXTENSIVE-PELVIS-HIP-SOFT-TISSUE-TUMOR-RESECTION-5CM-PLUS

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

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

CPT-27067-ILIUM-PUBIS-GREATER-TROCHANTER-BONE-CYST-EXCISION-WITH-AUTOGRAFT

CPT 27067: Excision of Bone Cyst or Benign Tumor with Autograft Reconstruction

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-27071-DEEP-PARTIAL-EXCISION-ILIUM-PUBIS-GREATER-TROCHANTER

CPT 27071: Deep Partial Excision of Ilium, Pubis, or Greater Trochanter

CPT-27050-OPEN-SACROILIAC-JOINT-BIOPSY

CPT 27050: Open Sacroiliac Joint Biopsy, Soft Tissue

CPT-27062-TROCHANTERIC-BURSA-EXCISION

CPT 27062: Excision of Trochanteric Bursa

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Taxonomy Code	Specialty	Notes
Data not available in the input.	Orthopedic Oncology	Focused on musculoskeletal tumor resection and reconstruction.
Data not available in the input.	Surgical Oncology	Manages complex oncologic resections of pelvic tumors.
Data not available in the input.	Plastic and Reconstructive Surgery	Provides soft-tissue coverage and reconstruction after wide pelvic resections.
Data not available in the input.	General Orthopedics	May assist with pelvic stabilization and fixation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C41.4`	Malignant neoplasm of pelvic bones, sacrum and coccyx	Primary malignant bone tumor of the pelvis that often necessitates radical pelvic bone resection such as `27075`.
`C41.8`	Malignant neoplasm of overlapping sites of bones, joints, and articular cartilage	Used when tumor spans multiple adjacent bony pelvic sites requiring radical resection.
`M85.8`	Other specified disorders of bone density and structure	May be used for certain benign aggressive lesions or structural bone disorders considered in differential diagnosis; relevance for surgical planning.
`D16.4`	Benign neoplasm of pelvic bones	Benign but locally aggressive tumors (e.g., osteoblastoma) that may require radical excision for local control.
`C41.9`	Malignant neoplasm of bone and articular cartilage, unspecified	Used when specific pelvic bone site not otherwise specified but malignant bone tumor requires radical resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27245`	Radical resection of tumor, proximal femur, with or without prosthetic reconstruction	May be performed when tumor involves proximal femur adjacent to the ilium or pelvic resection requires femoral resection for margin control.
`27350`	Radical resection of tumor, pelvis and sacrum (e.g., hemipelvectomy)	Performed for more extensive pelvic tumors; represents a larger pelvic procedure related in scope and planning to `27075`.
`11042`	Debridement; skin, subcutaneous tissue and muscle	May be performed for wound debridement in the postoperative period or intraoperatively for tissue trimming.
`20680`	Removal of deep implant (e.g., pelvic fixation hardware)	May be performed if hardware removal or placement is necessary during reconstruction or reoperation.
`20926`	Soft tissue allograft (includes plating and fixation when required)	May be used when reconstruction requires grafting or complex soft-tissue reconstruction alongside the resection.

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