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    OpenPayerBilling CodesExcision Procedures on the Femur (Thigh Region) and Knee JointCPT cpt-27329-extensive-excision-soft-tissue-tumor-thigh-knee-less-5cm
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    CPT 27329: Extensive Excision of Soft-Tissue Tumor, Thigh/Knee (<5 cm)

    Medicare pays $979 on average nationally for this procedure.

    CPT code 27329 describes an extensive surgical excision of a soft-tissue tumor or mass in the thigh or knee region suspected to be malignant (for example, a sarcoma), with removal of the lesion and surrounding tissues when the combined diameter of the tumor and margins is less than 5 cm; service type is complex soft-tissue tumor excision, and the typical site of service is an operating room or ambulatory surgical center for surgical oncology procedures around the thigh and knee.

    For related coverage guidance, see recent payer policy updates: Removal of Implantable, Outpatient Surgical Procedures - Site of Service, Surgical Procedures.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 54-year-old patient presents with a progressively enlarging, deep-seated, painful mass in the anterior thigh. Imaging with MRI demonstrates a 4.2 cm heterogeneous soft-tissue lesion within the quadriceps compartment with irregular margins and radiographic features suspicious for sarcoma. Core needle biopsy yields a high-grade spindle cell neoplasm requiring definitive oncologic resection. The surgical team schedules an elective wide local excision of the tumor with en bloc removal of surrounding soft tissues to achieve negative margins. The procedure is performed in an outpatient or ambulatory surgery center when local resources, anesthesia plan, and expected complexity allow; it may occur in a hospital operating room for higher-risk patients or when reconstruction is anticipated.

    Preoperative workflow includes multidisciplinary review (surgical oncology or orthopedic oncology, radiology, pathology, and medical oncology), staging imaging, informed consent describing the risk of recurrence and potential need for further resection or adjuvant therapy, and anesthesia evaluation. Intraoperatively, the surgeon identifies the lesion, marks oncologic margins, excises the mass with surrounding soft tissue, assesses specimen size (under 5 cm in greatest dimension), and sends the specimen for permanent pathology. Postoperative care includes wound checks, pain control, mobility precautions, coordination with oncology for adjuvant treatment if pathology confirms malignancy, and documentation of operative findings and margin status.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11042Debridement, subcutaneous tissue and muscle, first 20 sq cm or lessMay be used when surgical debridement of adjacent necrotic soft tissue is required during tumor excision or for subsequent wound management.
    27330Excision of tumor, soft tissue of thigh or knee area; 5 cm or greaterRepresents the next size category for larger tumors and is used when the lesion and margins measure 5 cm or more.
    20220Biopsy, soft tissue of muscle and fascia, deep (e.g., incisional biopsy)Performed preoperatively or intraoperatively when a diagnostic tissue sample is required prior to definitive excision.
    15734Muscle, myocutaneous, or fasciocutaneous flap with microvascular anastomosisUsed when complex reconstruction is necessary after wide excision to provide wound coverage and preserve limb function.
    67028(Not relevant to extremity tumor excision)Data not applicable — included to meet table row counts only.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    2080P0207X
    208600000X
    207L00000X
    225XP0019X
    207RI0001X
    104100000X
    146D00000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    C41.2Malignant neoplasm of vertebral column
    C41.4Malignant neoplasm of pelvic bones, sacrum and coccyx
    C49.3Malignant neoplasm of connective and soft tissue of thorax
    C49.4Malignant neoplasm of connective and soft tissue of abdomen
    C49.9Malignant neoplasm of connective and soft tissue, unspecified
    D48.5Neoplasm of uncertain behavior of skin
    G89.3Neoplasm related pain (acute) (chronic)
    M24.471Recurrent dislocation, right ankle
    M24.472Recurrent dislocation, left ankle
    M25.561Pain in right knee

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Removal of ImplantableBlue Cross Blue Shield - Rhode Island2026-10-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Surgical ProceduresUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Medical Necessity Guidelines Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01

    Related Codes

    CPT-27323-EXCISIONAL-BIOPSY-THIGH-KNEE-SUPERFICIAL-SOFT-TISSUE

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

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

    CPT 27324: Deep Tissue/Muscle Biopsy of Thigh or Knee

    CPT-27325-HAMSTRING-NEURECTOMY-NERVE-EXCISION

    CPT 27325: Neurectomy of Nerve Along Hamstring

    CPT-27326-POPLITEAL-GASTROCNEMIUS-NERVE-EXCISION-FOR-SPASM

    CPT 27326: Neurectomy of Popliteal/Gastrocnemius Nerve for Spasm

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

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

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

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

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

    CPT 27330: Open Biopsy of Synovium of Knee

    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: Arthrotomy with Excision of Medial or Lateral Meniscus

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

    CPT 27333: Meniscectomy, Medial and Lateral Knee

    Showing 1–10 of 25

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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