Billing code 27323: Soft-tissue biopsyMedicare rate & RVUs in Guam
Reports surgical sampling of superficial soft tissue in the thigh or knee area when a lesion requires tissue diagnosis rather than complete removal.
Medicare pays $296.57 for 27323 in the office in Guam (Hawaii, Guam). 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 27323 covers
A surgeon removes a sample of superficial soft tissue from the thigh or knee area so the tissue can be examined for a suspected tumor or other abnormality. Orthopedic surgeons and surgical oncologists commonly perform the procedure in an outpatient operating room or procedure setting. The code distinguishes a superficial biopsy from sampling deeper soft tissue and from biopsy of the knee joint lining.
Report this code when the operative record supports sampling superficial tissue, rather than complete excision of the lesion. Document the biopsy site, the tissue sampled, and the operative findings; the pathology service may be reported separately when performed by another provider. This minor procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral reporting, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this procedure; 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.
27323 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $296.57 | $163.27 |
How the 27323 rate is calculated
Each of 27323’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 · 27323
RVUs × geographic indexes × conversion factor
Work2.27
2.27 RVUs× 1.000 GPCI
Practice expense5.66
5.66 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
8.2300
Conversion factor
$33.4009
Medicare rate
$274.89
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27323
27323 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27323
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 · 27323
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
27323 without 50 · national office
$274.89
Soft-tissue biopsy
27323-50 · Bilateral: 150%
$412.34
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).
27323 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27324Thigh biopsy
- This code is for superficial soft tissue; 27324 is for deep soft-tissue biopsy. Use the operative description of tissue depth to distinguish them.
- 27327Soft-tissue excision
- Use this biopsy code when tissue is sampled. Code 27327 describes excision of a superficial thigh or knee-area lesion under its applicable size criterion.
- 27328Soft-tissue tumor excision
- This code reports superficial tissue sampling, while 27328 describes excision of a deep thigh or knee-area tumor under its applicable size criterion.
- 27330Knee biopsy
- This code samples superficial soft tissue around the thigh or knee; 27330 is for biopsy of the knee joint lining.
27323 billing questions
How do I distinguish this code from 27324?
Use 27323 for sampling superficial soft tissue in the thigh or knee area. Use 27324 when the biopsy is of deep soft tissue; the operative documentation should support the depth.
When is an excision code more appropriate?
This code describes sampling tissue, not removing the entire lesion. When the surgeon excises a superficial lesion or a deep tumor, consider the applicable excision code, such as 27327 or 27328, based on the documented procedure and lesion.
Can pathology be billed separately?
The surgeon's biopsy service and a pathologist's examination of the specimen are distinct services when each is performed and otherwise reportable. The operative record should identify the submitted tissue and the pathology report should document the examination.
What supports reporting the superficial level?
Document the thigh or knee-area site, the tissue sampled, and operative details that establish the biopsy was superficial rather than deep. A diagnosis of a mass alone does not establish the depth.
How does the 10-day global period affect follow-up?
Related postoperative visits during the 10 days after the biopsy are included in the global period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the multiple-procedure reduction.
How is a bilateral biopsy reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service at 150%. An assistant at surgery is not paid, 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 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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