No office rate
This code applies to superficial soft-tissue sampling in the pelvic or hip area; 27041 is for deep soft-tissue sampling.
On this page
CMS RVU26D · Effective 2026-10-01
27040 Soft-tissue biopsy Medicare reimbursement rates in Michigan
Reports surgical sampling of superficial soft tissue in the pelvis or hip region when tissue is needed for diagnostic evaluation. Compare 27040 office and facility rates across CMS payment localities in Michigan.
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 27040 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$323.65–$343.74
2 of 2 localities have a supported rate.
Facility setting
$178.19–$190.00
2 of 2 localities have a supported rate.
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.
Surgical biopsy
About 27040: Superficial pelvic or hip tissue biopsy
Reports surgical sampling of superficial soft tissue in the pelvis or hip region when tissue is needed for diagnostic evaluation.
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.
CMS billing rules for 27040
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.85 · 28%
- Practice expense (office) RVU6.96 · 68%
- Malpractice RVU0.43 · 4%
254
Medicare services in 2024 · #4126 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.
27040 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Use 27043 for excision of a subcutaneous lesion measuring 3 cm or more, not for sampling tissue alone.
$510.38–$548.88
Use 27047 for excision of a subcutaneous lesion smaller than 3 cm; 27040 reports a biopsy.
No office rate
This code samples soft tissue around the hip or pelvis. Code 27052 is for biopsy of the hip joint itself.
Compare 27040 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
$343.74
Facility
$190.00
Rest Of Michigan →
Office / nonfacility
$323.65
Facility
$178.19
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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 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.
2,71727033,,Arthrt hip expl/rmv loose/fb,A,,13.76,10.08,NA,10.08,,2.91,26.75,26.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71827035,,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