Summary & Overview
CPT 27364: Extensive Excision of Soft Tissue Tumor, Thigh or Knee ≥5 cm
CPT code 27364 covers the extensive surgical excision of a soft tissue tumor of the thigh or knee measuring 5 cm or greater. This code is clinically important because large soft tissue tumors often require more complex resections, multidisciplinary perioperative care, and may affect facility resource use and reimbursement patterns. Nationwide, use of this code signals procedures with higher operative complexity and potential downstream care needs.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on coding application, payer coverage considerations, and clinical context for large soft tissue tumor resections.
Readers will find: a clinical description of the procedure and typical sites of service; benchmarking information and payer coverage summaries where available; and policy or documentation elements that commonly affect coding and claim adjudication. Data not available in the input is noted where applicable. The content is intended to inform billing, coding, and policy audiences about the clinical and administrative aspects of CPT code 27364 without providing clinical recommendations.
Billing Code Overview
CPT code 27364 describes the extensive surgical removal of a soft tissue tumor and surrounding tissues in the thigh or knee region when the lesion measures 5 cm or more. This procedure represents a wide local excision of a large soft tissue neoplasm and is classified as a surgical soft-tissue oncology service.
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Service type: Major surgical excision of soft tissue tumor
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Typical site of service: Hospital operating room or ambulatory surgical center for procedures involving the thigh or knee
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with a progressively enlarging, deep soft tissue mass in the anterior thigh measuring greater than 5 cm on MRI, with pain and functional limitation of the knee. Core needle biopsy suspicious for high-grade sarcoma prompts referral to orthopedic oncology. Preoperative planning includes staging chest CT to evaluate for metastasis, multidisciplinary tumor board review, and consent for wide local excision of the tumor with an intended negative margin. The patient is admitted to an outpatient surgical center or hospital operating room (typical site of service: ambulatory surgical center or inpatient hospital) for general anesthesia, tumor resection of the thigh/knee region, hemostasis, possible intraoperative frozen section pathology, and placement of drains or wound closure. Postoperative care includes short inpatient observation or same-day discharge with wound care instructions, pain control, and outpatient surgical follow-up for pathology review and adjuvant treatment planning if malignancy is confirmed. This procedure is billed using 27364 for extensive excision of a soft tissue tumor 5 cm or greater in the thigh or knee region.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure was performed on the left thigh or left knee region |