Billing code 27040: Soft-tissue biopsyMedicare rate & RVUs in Florida
Reports surgical sampling of superficial soft tissue in the pelvis or hip region when tissue is needed for diagnostic evaluation.
Medicare pays $339.02–$373.52 for 27040 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27040 covers
A surgeon obtains a tissue sample from superficial soft tissue in the pelvis or hip region for diagnostic evaluation. Common settings include an outpatient operating room or hospital procedure suite, with orthopedic surgeons, general surgeons, or surgical oncologists performing the procedure. The target may be a palpable abnormality in the hip or buttock soft tissues; the biopsy samples tissue rather than removing a lesion in its entirety.
Report this code when the sampled tissue is superficial in the pelvic or hip area. The operative note should identify the site, describe the tissue sampled, and support that the procedure was a biopsy rather than complete lesion removal. Deeper soft-tissue sampling is reported with 27041. CMS includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
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.
Where 27040 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$339.02 to $373.52
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $356.65 | $195.26 |
| Miami | $373.52 | $207.66 |
| Rest Of Florida | $339.02 | $186.71 |
How the 27040 rate is calculated
Each of 27040’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27040
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.85Practice expense 6.96Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27040
27040 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27040
Soft-tissue biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27040
Soft-tissue biopsy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27040 without 50 · national office
$342.03
Soft-tissue biopsy
27040-50 · Bilateral: 150%
$513.05
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27040 compared with similar codes
Compare codes
27040 vs 27041 vs 27043 vs 27047 vs 27052: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27041Soft-tissue biopsy
- This code applies to superficial soft-tissue sampling in the pelvic or hip area; 27041 is for deep soft-tissue sampling.
- 27043Soft-tissue excision
- Use 27043 for excision of a subcutaneous lesion measuring 3 cm or more, not for sampling tissue alone.
- 27047Soft tissue excision
- Use 27047 for excision of a subcutaneous lesion smaller than 3 cm; 27040 reports a biopsy.
- 27052Joint biopsy
- This code samples soft tissue around the hip or pelvis. Code 27052 is for biopsy of the hip joint itself.
27040 billing questions
How does 27040 differ from 27041?
27040 is for superficial soft tissue in the pelvis or hip area. Use 27041 when the sampled soft tissue is deep.
Should this code be used when the entire lesion is removed?
No. This code represents tissue sampling. When the surgeon removes a soft-tissue lesion rather than taking a biopsy, select the applicable excision code based on site, depth, and lesion size.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How is bilateral reporting paid?
CMS identifies this as a bilateral procedure; when reported with modifier 50, it is paid at 150%.
Can an assistant, co-surgeon, or surgical team be paid for this procedure?
Assistant-at-surgery payment is restricted. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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