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CPT 27326: Popliteal/Gastrocnemius Nerve Excision to Relieve Spasm

CPT code 27326 denotes excision of part of a nerve in the popliteal or gastrocnemius muscle to relieve muscle spasms. Nationally, this code identifies a focused surgical intervention used in management of focal spasticity or refractory muscle hyperactivity of the posterior lower leg. It is relevant to surgical practices, neurology and physiatry services, and facilities that provide operative management of peripheral nerve–related spasm.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is categorized clinically, typical sites of service, and the procedural intent. The publication also outlines common billing considerations and benchmarking context where available.

This content is designed for national audiences seeking a clear clinical and billing reference for CPT code 27326, providing the clinical context, payer coverage landscape, and the types of benchmarks and policy information typically reviewed when evaluating utilization and reimbursement for this procedure. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 27326 describes a surgical procedure in which the provider excises part of a nerve from the popliteal or gastrocnemius muscle to relieve muscle spasms. This is a targeted neuromuscular intervention intended to reduce spasticity or focal muscle hyperactivity in the posterior lower leg.

Service type: Surgical neuromuscular procedure
Typical site of service: Operating room or ambulatory surgical center where soft-tissue and peripheral nerve procedures are performed

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CPT 27326: Popliteal/Gastrocnemius Nerve Excision to Relieve Spasm

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Billing Code Overview

Service type: Surgical neuromuscular procedure
Typical site of service: Operating room or ambulatory surgical center where soft-tissue and peripheral nerve procedures are performed

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient with chronic, focal gastrocnemius muscle spasm refractory to conservative measures presents for surgical management. The patient reports persistent calf pain and involuntary muscle contractions worsening daily despite physical therapy, oral muscle relaxants, and botulinum toxin injections. Preoperative evaluation by the orthopedic surgeon and anesthesiologist includes focused lower-extremity neurovascular exam, review of prior electromyography (EMG) and nerve conduction studies demonstrating focal motor nerve hyperactivity, and imaging to rule out compressive pathology. In the operating room under regional or general anesthesia, the surgeon performs a partial excision or resection of a branch of the tibial nerve supplying the gastrocnemius/popliteal region to relieve spasm. Postoperative workflow includes immediate neurovascular checks, pain control, physical therapy planning, and documentation of laterality and any intraoperative events for coding and billing. Typical site of service is an ambulatory surgery center or hospital outpatient department. Service type is surgical – peripheral nerve procedure of the popliteal/gastrocnemius region.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Use when no specific modifier applies and the procedure is billed as reported.
`11`	Office/Outpatient Evaluation and Management (historical CMS modifier for principal physician)	Rarely used; applicable if payer requires modifier for the primary reporting physician in outpatient settings (verify payer rules).
`22`	Increased Procedural Services	Use when the procedure required substantially greater effort, time, or technical difficulty than usual; documentation must support the increased services.
`52`	Reduced Services	Use when the procedure was partially reduced or not completed; documentation must explain why full service was not performed.
`53`	Discontinued Procedure	Use when the procedure is started but terminated due to patient status or intraoperative complications and is not completed.
`62`	Two Surgeons	Use when two surgeons of different specialties work together as primary surgeons performing distinct portions of the procedure.
`50`	Bilateral Procedure (note: many payers require modifier per CPT guidance)	Use when identical procedures are performed on both extremities; some payers prefer modifier `RT`/`LT` instead—follow payer rules.
`LT`	Left Side	Use to indicate the procedure was performed on the left lower extremity when laterality is required.
`RT`	Right Side	Use to indicate the procedure was performed on the right lower extremity when laterality is required.
`51`	Multiple Procedures	Use when multiple distinct procedures are performed in the same operative session; report highest-valued procedure first and append `51` to subsequent codes per payer rules.
`78`	Return to OR for Unplanned Procedure Following Initial Surgery	Use when the patient returns to the operating room for a related unplanned procedure during the postoperative period.
`79`	Unrelated Procedure or Service During Postoperative Period (not in provided list)	Data not available in the input.
`26`	Professional Component	Use if only the professional component of a global service is billed (more relevant for imaging/diagnostic tests).
`73`	Discontinued Outpatient Procedure Prior to Anesthesia	Use when a procedure is canceled after anesthesia has been administered in the outpatient setting (documentation required).

Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Orthopedic surgeons commonly perform peripheral nerve procedures of the lower extremity to relieve muscle spasm.
2080P0205X	Physical Medicine & Rehabilitation	PM&R physicians may coordinate care pre- and postoperatively and perform diagnostic procedures; less commonly the surgeon for excision.
207X00000X	Neurological Surgery	Neurosurgeons may perform peripheral nerve surgery in complex or refractory cases.
213E00000X	Podiatry	Podiatrists with surgical privileges may perform lower-extremity nerve procedures depending on scope and setting.
207L00000X	General Surgery (orthopedic subspecialty overlap)	General surgeons seldom perform this but may be involved in multidisciplinary cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20550`	Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)	Used prior to surgery for diagnostic relief or conservative management of focal gastrocnemius spasms.
`20552`	Injection(s); trigger point(s), more than 2 muscle(s)	Used when multiple muscles are targeted for nonoperative spasm management.
`20560`	Injection, therapeutic, including anesthetic agent; tendon sheath, ligament, ganglion cyst	Occasionally used for diagnostic or adjunct injections around the posterior knee.
`95886`	Needle electromyography; 1 extremity with or without related paraspinal areas, 1–2 muscles	Preoperative EMG studies to localize nerve hyperactivity contributing to spasms.
`95885`	Needle electromyography; 1 extremity with or without related paraspinal areas, 3–4 muscles	Alternate EMG study code when more muscles are studied for localization.
`64450`	Injection, anesthetic agent; sciatic nerve, single	Perioperative or diagnostic nerve block of the sciatic nerve for pain control or localization prior to definitive excision.
`27759`	Other open or percutaneous incisions or excisions of lesion of popliteal area (example code)	Related soft-tissue or lesion excisions in the popliteal region that may be performed in the same operative session.

CPT 27323: Excisional Biopsy of Superficial Soft Tissue, Thigh or Knee

CPT-27324-DEEP-SOFT-TISSUE-BIOPSY-THIGH-KNEE

CPT 27324: Open Deep Soft-Tissue Biopsy of Thigh or Knee

CPT-27325-HAMSTRING-NEURECTOMY-NERVE-EXCISION

CPT 27325: Hamstring Neurectomy for Painful Muscle Spasms

CPT-27327-SUBCUTANEOUS-TUMOR-EXCISION-THIGH-KNEE

CPT 27327: Excision of Subcutaneous Tumor, Thigh/Knee (<3 cm)

CPT-27328-INTRAMUSCULAR-THIGH-KNEE-TUMOR-EXCISION-SMALL

CPT 27328: Excision of Intramuscular Tumor of Thigh or Knee (<5 cm)

CPT-27329-EXTENSIVE-EXCISION-SOFT-TISSUE-TUMOR-THIGH-KNEE-LESS-5CM

CPT 27329: Extensive Excision of Soft Tissue Tumor, Thigh or Knee (<5 cm)

CPT-27330-KNEE-SYNOVIAL-BIOPSY-SURGICAL-DIAGNOSTIC

CPT 27330: Knee Synovial Biopsy, Open Surgical Diagnostic

CPT-27331-KNEE-ARTHROTOMY-BIOPSY-LOOSE-BODY-REMOVAL

CPT 27331: Knee Arthrotomy with Synovial Biopsy and Loose Body Removal

CPT-27332-KNEE-ARTHROTOMY-MENISCAL-EXCISION

CPT 27332: Knee Arthrotomy with Meniscal Excision

CPT-27333-KNEE-PARTIAL-MENISCECTOMY-MEDIAL-AND-LATERAL

CPT 27333: Knee Partial Meniscectomy, Medial and Lateral

Showing 1–10 of 25

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
`00`	No modifier (default)	Use when no specific modifier applies and the procedure is billed as reported.
`11`	Office/Outpatient Evaluation and Management (historical CMS modifier for principal physician)	Rarely used; applicable if payer requires modifier for the primary reporting physician in outpatient settings (verify payer rules).
`22`	Increased Procedural Services	Use when the procedure required substantially greater effort, time, or technical difficulty than usual; documentation must support the increased services.
`52`	Reduced Services	Use when the procedure was partially reduced or not completed; documentation must explain why full service was not performed.
`53`	Discontinued Procedure	Use when the procedure is started but terminated due to patient status or intraoperative complications and is not completed.
`62`	Two Surgeons	Use when two surgeons of different specialties work together as primary surgeons performing distinct portions of the procedure.
`50`	Bilateral Procedure (note: many payers require modifier per CPT guidance)	Use when identical procedures are performed on both extremities; some payers prefer modifier `RT`/`LT` instead—follow payer rules.
`LT`	Left Side	Use to indicate the procedure was performed on the left lower extremity when laterality is required.
`RT`	Right Side	Use to indicate the procedure was performed on the right lower extremity when laterality is required.
`51`	Multiple Procedures	Use when multiple distinct procedures are performed in the same operative session; report highest-valued procedure first and append `51` to subsequent codes per payer rules.
`78`	Return to OR for Unplanned Procedure Following Initial Surgery	Use when the patient returns to the operating room for a related unplanned procedure during the postoperative period.
`79`	Unrelated Procedure or Service During Postoperative Period (not in provided list)	Data not available in the input.
`26`	Professional Component	Use if only the professional component of a global service is billed (more relevant for imaging/diagnostic tests).
`73`	Discontinued Outpatient Procedure Prior to Anesthesia	Use when a procedure is canceled after anesthesia has been administered in the outpatient setting (documentation required).

Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Orthopedic surgeons commonly perform peripheral nerve procedures of the lower extremity to relieve muscle spasm.
2080P0205X	Physical Medicine & Rehabilitation	PM&R physicians may coordinate care pre- and postoperatively and perform diagnostic procedures; less commonly the surgeon for excision.
207X00000X	Neurological Surgery	Neurosurgeons may perform peripheral nerve surgery in complex or refractory cases.
213E00000X	Podiatry	Podiatrists with surgical privileges may perform lower-extremity nerve procedures depending on scope and setting.
207L00000X	General Surgery (orthopedic subspecialty overlap)	General surgeons seldom perform this but may be involved in multidisciplinary cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20550`	Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)	Used prior to surgery for diagnostic relief or conservative management of focal gastrocnemius spasms.
`20552`	Injection(s); trigger point(s), more than 2 muscle(s)	Used when multiple muscles are targeted for nonoperative spasm management.
`20560`	Injection, therapeutic, including anesthetic agent; tendon sheath, ligament, ganglion cyst	Occasionally used for diagnostic or adjunct injections around the posterior knee.
`95886`	Needle electromyography; 1 extremity with or without related paraspinal areas, 1–2 muscles	Preoperative EMG studies to localize nerve hyperactivity contributing to spasms.
`95885`	Needle electromyography; 1 extremity with or without related paraspinal areas, 3–4 muscles	Alternate EMG study code when more muscles are studied for localization.
`64450`	Injection, anesthetic agent; sciatic nerve, single	Perioperative or diagnostic nerve block of the sciatic nerve for pain control or localization prior to definitive excision.
`27759`	Other open or percutaneous incisions or excisions of lesion of popliteal area (example code)	Related soft-tissue or lesion excisions in the popliteal region that may be performed in the same operative session.

CPT 27323: Excisional Biopsy of Superficial Soft Tissue, Thigh or Knee

CPT-27324-DEEP-SOFT-TISSUE-BIOPSY-THIGH-KNEE

CPT 27324: Open Deep Soft-Tissue Biopsy of Thigh or Knee

CPT-27325-HAMSTRING-NEURECTOMY-NERVE-EXCISION

CPT 27325: Hamstring Neurectomy for Painful Muscle Spasms

CPT-27327-SUBCUTANEOUS-TUMOR-EXCISION-THIGH-KNEE

CPT 27327: Excision of Subcutaneous Tumor, Thigh/Knee (<3 cm)

CPT-27328-INTRAMUSCULAR-THIGH-KNEE-TUMOR-EXCISION-SMALL

CPT 27328: Excision of Intramuscular Tumor of Thigh or Knee (<5 cm)

CPT-27329-EXTENSIVE-EXCISION-SOFT-TISSUE-TUMOR-THIGH-KNEE-LESS-5CM

CPT 27329: Extensive Excision of Soft Tissue Tumor, Thigh or Knee (<5 cm)

CPT-27330-KNEE-SYNOVIAL-BIOPSY-SURGICAL-DIAGNOSTIC

CPT 27330: Knee Synovial Biopsy, Open Surgical Diagnostic

CPT-27331-KNEE-ARTHROTOMY-BIOPSY-LOOSE-BODY-REMOVAL

CPT 27331: Knee Arthrotomy with Synovial Biopsy and Loose Body Removal

CPT-27332-KNEE-ARTHROTOMY-MENISCAL-EXCISION

CPT 27332: Knee Arthrotomy with Meniscal Excision

CPT-27333-KNEE-PARTIAL-MENISCECTOMY-MEDIAL-AND-LATERAL

CPT 27333: Knee Partial Meniscectomy, Medial and Lateral

Showing 1–10 of 25

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.

OpenPayer

CPT 27326: Popliteal/Gastrocnemius Nerve Excision to Relieve Spasm

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Billing Code Overview

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CPT 27326: Popliteal/Gastrocnemius Nerve Excision to Relieve Spasm

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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