$580.23–$617.65
Both codes describe soft-tissue biopsy in the leg or ankle; choose 27613 for superficial tissue and 27614 for deep tissue.
On this page
CMS RVU26D · Effective 2026-10-01
27613 Soft-tissue biopsy Medicare reimbursement rates in Michigan
Reports operative sampling of superficial soft tissue in the leg or ankle when a clinician needs tissue for diagnosis rather than definitive lesion removal. Compare 27613 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 27613 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
$246.82–$262.20
2 of 2 localities have a supported rate.
Facility setting
$146.50–$156.16
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.
Musculoskeletal surgery
About 27613: Superficial lower-leg soft-tissue biopsy
Reports operative sampling of superficial soft tissue in the leg or ankle when a clinician needs tissue for diagnosis rather than definitive lesion removal.
This code describes obtaining a diagnostic tissue sample from superficial soft tissue in the leg or ankle. It fits situations such as evaluating a palpable subcutaneous mass whose nature is uncertain. Orthopedic surgeons and other physicians who perform musculoskeletal procedures may provide the service in an office procedure room or an operating or treatment facility. The sampled tissue is sent for diagnostic evaluation; the code represents the biopsy procedure, not definitive removal of the lesion.
Choose this code when the sampled tissue is superficial, rather than deep, and document the leg or ankle site, tissue depth, biopsy purpose, and work performed. A deep soft-tissue biopsy is reported with 27614. The service has a 10-day global period, including related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral performance, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 27613
- 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 RVU2.16 · 28%
- Practice expense (office) RVU5.32 · 68%
- Malpractice RVU0.33 · 4%
891
Medicare services in 2024 · #3053 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.
27613 compared with similar codes
Office rates for Michigan, from the same CMS release.
$490.13–$523.54
27613 represents diagnostic sampling. Use 27618 when a subcutaneous leg or ankle tumor under 3 cm is excised rather than sampled.
No office rate
27613 is a biopsy for diagnosis; 27615 describes resection of a leg or ankle soft-tissue tumor under 5 cm.
Compare 27613 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
$262.20
Facility
$156.16
Rest Of Michigan →
Office / nonfacility
$246.82
Facility
$146.50
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27613 billing questions
How do I distinguish 27613 from 27614?
Use 27613 for a superficial soft-tissue biopsy in the leg or ankle and 27614 when the biopsy is deep. The operative note should support the depth of the sampled tissue.
Can I report this code when the entire mass is removed?
This code is for diagnostic sampling. When the procedure removes a lesion rather than taking a sample, select the applicable excision or resection code based on the procedure and lesion characteristics.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How is bilateral performance reported?
Report bilateral performance with modifier 50; CMS pays the bilateral procedure at 150%.
How does the multiple procedure reduction affect this code?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery 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 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.
2,96927607,,Treat lower leg bone lesion,A,,8.40,6.93,NA,6.93,,1.65,16.98,16.98,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97027610,,Explore/treat ankle joint,A,,8.90,7.71,NA,7.71,,1.64,18.25,18.25,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97127612,,Exploration of ankle joint,A,,7.95,7.01,NA,7.01,,1.25,16.21,16.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97227613,,Biopsy lower leg soft tissue,A,,2.16,5.32,,2.03,,0.33,7.81,4.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97327614,,Biopsy lower leg soft tissue,A,,5.66,11.69,,5.15,,0.92,18.27,11.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97427615,,Resect leg/ankle tum < 5 cm,A,,15.33,9.61,NA,9.61,,3.29,28.23,28.23,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97527616,,Resect leg/ankle tum 5 cm/>,A,,19.14,11.38,NA,11.38,,4.17,34.69,34.69,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00