Billing code 27618: Soft-tissue excisionMedicare rate & RVUs in Guam
Reports excision of a subcutaneous soft-tissue tumor under 3 cm in the leg or ankle, such as a small superficial lipoma.
Medicare pays $557.20 for 27618 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 27618 covers
This code describes excision of a soft-tissue tumor smaller than 3 cm that lies beneath the skin but remains subcutaneous in the leg or ankle area. An orthopedic surgeon or another surgeon may perform it in an operating room or an outpatient procedure setting. A small superficial lipoma is a typical example; the operative report should establish the mass’s location, size, and depth.
Choose this code when the surgeon removes the tumor, not when only a tissue sample is taken. Distinguish it from codes for larger subcutaneous tumors and for tumors beneath the fascia. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 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.
27618 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $557.20 | $306.93 |
How the 27618 rate is calculated
Each of 27618’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 · 27618
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.86Practice expense 10.88Malpractice 0.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27618
27618 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27618
Soft-tissue excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27618
Soft-tissue excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27618 without 50 · national office
$518.38
Soft-tissue excision
27618-50 · Bilateral: 150%
$777.57
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).
27618 compared with similar codes
Compare codes
27618 vs 27619 vs 27632 vs 27615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27619Soft-tissue excision
- Use 27618 for a subcutaneous tumor under 3 cm; 27619 describes a deep soft-tissue tumor under 5 cm.
- 27632Soft-tissue excision
- 27632 is for a subcutaneous leg or ankle lesion 3 cm or larger. 27618 is limited to a tumor under 3 cm.
- 27615Tumor resection
- 27615 describes resection of a subcutaneous leg or ankle tumor under 5 cm. 27618 describes excision of a subcutaneous tumor under 3 cm; the operative procedure and documented size distinguish them.
27618 billing questions
How does 27618 differ from 27619?
27618 is for a subcutaneous tumor under 3 cm. 27619 is for a deep soft-tissue tumor under 5 cm.
Is 27618 appropriate when the surgeon takes only a biopsy?
No. This code describes excision of the tumor, rather than sampling only part of it. Consider the applicable soft-tissue biopsy code when the surgeon obtains tissue for diagnosis without removing the entire mass.
What documentation supports 27618?
The operative report should identify the leg or ankle site, document that the tumor is subcutaneous, and record its size as under 3 cm. It should also describe removal of the tumor.
How is bilateral reporting handled?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support a qualifying procedure on both sides.
Can an assistant surgeon or co-surgeon be reported?
CMS restricts assistant-at-surgery payment for this code. 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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