27059 Tumor resection Medicare reimbursement rates in Kentucky

This code describes operative resection of a soft-tissue tumor in the pelvis or hip area when the tumor measures at least 5 cm. A typical case may involve a large mass, including a suspected sarcoma, treated by an orthopedic oncologist or surgical oncologist in an operating room. The code is specific to the pelvic or hip region; it is not the code for removal of a tumor arising in bone.

Select the code using the documented tumor size, anatomic location, and operation performed. The operative report should identify the tumor site, its measured size, and the resection performed; size alone does not distinguish this code from codes for excision of soft-tissue tumors. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.