Billing code 27613: Soft-tissue biopsyMedicare rate & RVUs in Oregon
Reports operative sampling of superficial soft tissue in the leg or ankle when a clinician needs tissue for diagnosis rather than definitive lesion removal.
Medicare pays $256.88–$278.92 for 27613 in the office in Oregon, from Rest Of Oregon to Portland. 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 27613 covers
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.
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.
Where 27613 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $278.92 | $156.83 |
| Rest Of Oregon | $256.88 | $147.43 |
How the 27613 rate is calculated
Each of 27613’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 · 27613
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.16Practice expense 5.32Malpractice 0.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27613
27613 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27613
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 · 27613
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
27613 without 50 · national office
$260.86
Soft-tissue biopsy
27613-50 · Bilateral: 150%
$391.29
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).
27613 compared with similar codes
Compare codes
27613 vs 27614 vs 27618 vs 27615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27614Soft-tissue biopsy
- Both codes describe soft-tissue biopsy in the leg or ankle; choose 27613 for superficial tissue and 27614 for deep tissue.
- 27618Soft-tissue excision
- 27613 represents diagnostic sampling. Use 27618 when a subcutaneous leg or ankle tumor under 3 cm is excised rather than sampled.
- 27615Tumor resection
- 27613 is a biopsy for diagnosis; 27615 describes resection of a leg or ankle soft-tissue tumor under 5 cm.
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 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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