$338.26
Choose 27041 for deep pelvic or hip-area soft tissue and 27040 for superficial soft tissue in that area.
On this page
CMS RVU26D · Effective 2026-10-01
27041 Soft-tissue biopsy Medicare reimbursement rates in Delaware
Reports an operative biopsy of deep soft tissue in the pelvis or hip area when a tissue sample is needed for diagnosis rather than lesion removal. Compare 27041 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27041 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$646.80
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Musculoskeletal surgery
About 27041: Deep pelvic soft-tissue biopsy
Reports an operative biopsy of deep soft tissue in the pelvis or hip area when a tissue sample is needed for diagnosis rather than lesion removal.
A surgeon obtains a tissue sample from a deep soft-tissue abnormality in the pelvis or hip area, typically to investigate a suspected tumor or another disorder requiring tissue diagnosis. The procedure involves surgical exposure of the target and sampling of the deep tissue; it is commonly performed in an operating room, often by an orthopedic or other surgeon managing a pelvic or hip-region lesion. It is distinct from sampling a joint or bone and from removing the lesion as treatment.
Select this code when the operative report supports a deep soft-tissue biopsy in the specified area. Document the site, depth, target, and that the procedure sampled tissue rather than excising the lesion. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. When performed bilaterally with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 27041
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.93 · 51%
- Practice expense (office) RVU7.67 · 39%
- Malpractice RVU2.01 · 10%
347
Medicare services in 2024 · #3871 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
27041 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
27043 describes excision of a qualifying subcutaneous hip or pelvic lesion; 27041 describes sampling deep soft tissue for diagnosis.
No office rate
27045 is for excision of a qualifying deep hip or pelvic tumor. Use 27041 when the procedure is a biopsy rather than tumor removal.
No office rate
27052 is a hip-joint biopsy. Use 27041 for a deep soft-tissue target outside the joint.
Compare 27041 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$646.80
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27041 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,721
- Code
- 27041
- Physician work
- 9.93
- Practice expense
- 7.67
- Malpractice
- 2.01
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.93 | × 1.005 | 9.9796 |
| Practice expense | 7.67 | × 0.988 | 7.5780 |
| Malpractice | 2.01 | × 0.899 | 1.8070 |
| Total RVUs | 19.3646 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$646.80
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.93 | 1.005 |
| Practice expense | 7.67 | 0.988 |
| Malpractice | 2.01 | 0.899 |
(9.93 × 1.005 + 7.67 × 0.988 + 2.01 × 0.899) × $33.4009 = $646.80
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27041 billing questions
How does this differ from 27040?
27041 is for deep soft tissue in the pelvis or hip area. 27040 is the corresponding code for a superficial biopsy.
Can the surgeon report this when the lesion is removed?
Use a biopsy code when tissue is sampled for diagnosis. When the lesion is excised, consider the applicable excision code instead, based on site, depth, and size.
Does this code cover a hip-joint or bone biopsy?
No. It describes deep soft tissue in the pelvis or hip area; a hip-joint biopsy or bone biopsy is a different service.
What should the operative report establish?
Document the pelvic or hip-area location, the deep soft-tissue target, the sampling performed, and whether the lesion was biopsied or excised.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,71827035,,Denervation of hip joint,A,,16.94,13.17,NA,13.17,,0.89,31.00,31.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71927036,,Capsulectomy/capsulotomy hip,A,,14.02,11.24,NA,11.24,,2.97,28.23,28.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72027040,,Biopsy of soft tissues,A,,2.85,6.96,,2.19,,0.43,10.24,5.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72127041,,Biopsy of soft tissues,A,,9.93,7.67,NA,7.67,,2.01,19.61,19.61,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72227043,,Exc hip pelvis les sc 3 cm/>,A,,6.71,5.23,NA,5.23,,1.65,13.59,13.59,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72327045,,Exc hip/pelv tum deep 5 cm/>,A,,10.85,7.43,NA,7.43,,2.43,20.71,20.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72427047,,Exc hip/pelvis les sc < 3 cm,A,,4.82,10.06,,4.58,,1.13,16.01,10.53,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503