CPT 27619 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 27619: Excision of Deep Soft-Tissue Tumor, Leg/Ankle (<5 cm)

CPT code 27619 denotes surgical excision of a tumor located beneath the fascia or within muscle of the leg or ankle when the lesion is under 5 cm. This code captures a focused deep soft-tissue excision that preserves surrounding normal tissue and is commonly billed for small intramuscular or subfascial masses in the lower extremity. Nationally, accurate use of this code affects surgical case reporting, resource allocation in ambulatory surgery centers and hospitals, and appropriate payment for soft-tissue tumor procedures.

Key payers included in the scope are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find clinical context explaining the procedure type and typical sites of service, a synopsis of common billing modifiers and coding considerations, and a review of related coding concepts. The publication provides benchmarking context and policy-relevant notes for national payers and facilities, and flags areas where documentation should support the depth of dissection and lesion size. Data not provided in the input are identified explicitly where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27619leg tumor excisionankle tumor excisionsoft tissue surgeryorthopedic surgeryambulatory surgery centeroperative codingsurgical oncologyprocedure coding

Billing Code Overview

CPT code 27619 describes the surgical excision of a tumor located beneath the fascia or within the muscle of the leg or ankle when the tumor measures less than 5 cm in diameter. This procedure involves removal of the lesion without excising a significant amount of surrounding normal tissue.

Service type: Surgical tumor excision (deep soft tissue), leg or ankle
Typical site of service: Operating room or ambulatory surgical center for lower-extremity soft-tissue tumor removal

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents to the orthopedic clinic with a deep, palpable mass in the posterior compartment of the lower leg noted on exam and imaging. MRI shows a well-circumscribed soft tissue tumor located within the gastrocnemius muscle, measuring 3.5 cm in greatest diameter and suspicious for a benign neoplasm. The patient is scheduled for an outpatient excision of the intramuscular lesion under general or regional anesthesia. The preoperative workflow includes history and physical, informed consent documenting risks and expected margins, anesthesia evaluation, and surgical site marking. Intraoperative steps include a longitudinal incision over the mass, dissection through subcutaneous tissue and fascia to expose the tumor within muscle, careful excision of the lesion with minimal removal of surrounding normal tissue, hemostasis, possible placement of a drain if needed, and layered closure. Specimen is sent for pathology. Postoperative management includes recovery monitoring, pain control, wound care instructions, and pathology follow-up for definitive diagnosis. Typical site of service is an ambulatory surgery center or hospital outpatient department for soft tissue tumor excision of the leg/ankle region. Service type: surgical excision of a deep (subfascial/intramuscular) soft tissue tumor less than 5 cm in diameter (27619).

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

CPT 27615: Extensive Excision of Soft Tissue Tumor, Leg/Ankle (<5 cm)

CPT-27638-TIBIA-FIBULA-BONE-CYST-ALLOGRAFT

CPT 27638: Tibia/Fibula Bone Cyst Excision with Allograft

CPT-27620-ANKLE-JOINT-EXPLORATION-OPEN-DIAGNOSTIC

CPT 27620: Open Diagnostic Exploration of Ankle Joint

CPT-27645-TIBIAL-TUMOR-RESECTION-WIDE-MARGINS

CPT 27645: Tibial Tumor Resection with Wide Margins

CPT-27634-DEEP-TISSUE-TUMOR-EXCISION-LEG-ANKLE-5CM-OR-GREATER

CPT 27634: Excision of Deep Soft-Tissue Tumor, Leg/Ankle ≥5 cm

CPT-27637-TIBIA-FIBULA-BONE-CYST-EXCISION-AUTOGRAFT-REPAIR

CPT 27637: Excision of Tibia or Fibula Bone Cyst with Autograft Repair

CPT-27630-TENDON-SHEATH-CAPSULE-LESION-EXCISION-LEG-ANKLE

CPT 27630: Excision of Tendon Sheath or Capsule Lesion, Leg/Ankle

CPT-27618-SUBCUTANEOUS-TUMOR-EXCISION-LESS-THAN-3CM

CPT 27618: Excision of Subcutaneous Tumor (<3 cm)

CPT-27625-ANKLE-SYNOVECTOMY-OPEN-SURGICAL-PROCEDURE

CPT 27625: Ankle Synovectomy, Open Surgical Procedure

CPT-27626-ANKLE-TENDON-SHEATH-EXCISION-SYNOVECTOMY

CPT 27626: Excision of Ankle Tendon Sheath with Synovectomy

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Taxonomy Code	Specialty	Notes
207K00000X	Orthopedic Surgery	Orthopedic surgeons commonly perform deep soft tissue tumor excisions of the leg and ankle.
207L00000X	Plastic Surgery	Plastic surgeons perform soft tissue tumor excisions when reconstruction or complex closure is anticipated.
207P00000X	General Surgery	General surgeons may perform extremity soft tissue excisions depending on practice setting.
208000000X	Dermatology	Dermatologic surgeons perform some soft tissue tumor excisions but deeper intramuscular lesions are less common.
261QM0800X	Podiatric Surgery	Podiatric surgeons may manage soft tissue tumors localized to the ankle and foot region.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M79.2`	Neuralgia and neuritis, unspecified	Deep soft tissue masses can cause local neuropathic pain or represent neural tumors.
`M79.601`	Pain in right leg	Symptom code that may prompt imaging and subsequent excision of a painful intramuscular mass.
`M79.602`	Pain in left leg	Symptom-based reason for evaluation and surgical management when present on the left.
`D48.6`	Neoplasm of uncertain behavior of soft tissue of lower limb, including hip	Used when preoperative diagnosis is indeterminate and lesion requires excision for diagnosis.
`C49.A1`	Malignant neoplasm of connective and soft tissue of left lower limb, including hip	Used if pathology confirms malignancy requiring excision and oncologic follow-up.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11055`	Debridement of partial-thickness wounds, up to 20 sq cm, first 20 sq cm or less	May be used postoperatively if wound debridement is required during follow-up care.
`12032`	Repair, intermediate, wounds of extremities and trunk, 2.6 cm to 7.5 cm	Commonly billed for layered closure of moderate-length incisions following tumor excision when closure complexity meets definition.
`20005`	Excision of subcutaneous tumor, <3 cm	Alternative for more superficial subcutaneous tumors; contrasts with `27619` which is intramuscular/subfascial.
`20550`	Injection(s); single tendon sheath, ligament, or ganglion cyst	May be relevant for diagnostic or therapeutic injections when a mass is cystic or inflammatory in etiology pre- or post-op.
`11043`	Debridement, muscle and/or fascia, first 20 sq cm	May be reported if significant debridement of muscle/fascia is performed in conjunction with tumor excision.

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