No office rate
This is the size sibling for radical resection: 27616 applies at 5 cm or greater; 27615 applies below 5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
27616 Tumor resection Medicare reimbursement rates in Pennsylvania
Reports radical removal of a soft-tissue tumor in the leg or ankle area when the tumor measures 5 cm or greater. Compare 27616 office and facility rates across CMS payment localities in Pennsylvania.
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 27616 in Pennsylvania?
Pennsylvania 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
No supported rate
Facility setting
$1119.85–$1212.65
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.
Orthopedic surgery
About 27616: Radical leg or ankle soft-tissue tumor resection
Reports radical removal of a soft-tissue tumor in the leg or ankle area when the tumor measures 5 cm or greater.
This code describes radical resection of a soft-tissue tumor in the leg or ankle area measuring at least 5 cm. It is used for definitive removal, such as oncologic surgery for a suspected or confirmed soft-tissue malignancy, rather than a diagnostic sample or a routine limited excision. Orthopedic oncologists and other surgeons may perform the operation in a hospital or outpatient surgical setting, depending on the patient and procedure.
Choose the code based on the tumor’s size and the radical extent of the operation; document the site, tumor dimensions, and operative approach. The 90-day global period includes 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity, and co-surgeon payment requires supporting documentation; team surgery is not permitted.
CMS billing rules for 27616
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.14 · 55%
- Practice expense (office) RVU11.38 · 33%
- Malpractice RVU4.17 · 12%
323
Medicare services in 2024 · #3939 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.
27616 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
27634 describes excision of a deep or subfascial tumor in the leg or ankle area. 27616 is for radical tumor resection at the 5 cm-or-greater threshold.
$245.68–$271.57
27613 is for diagnostic soft-tissue biopsy in the lower-leg or ankle area. 27616 is for definitive radical removal of a qualifying tumor.
Compare 27616 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1212.65
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1119.85
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27616 billing questions
How is this distinguished from 27615?
Both describe radical resection of a leg or ankle soft-tissue tumor. Use 27616 for a tumor 5 cm or greater and 27615 for one smaller than 5 cm.
How does this differ from 27634?
27616 describes radical tumor resection at the 5 cm threshold. 27634 describes excision of a deep or subfascial leg or ankle tumor; select based on the operation performed and the applicable code definition.
Can a biopsy be reported with the resection?
This code represents definitive tumor removal, not diagnostic sampling. Document any separately performed diagnostic procedure and assess whether it is separately reportable for that encounter.
What documentation supports reporting 27616?
Record the tumor’s leg or ankle location, its dimensions establishing the 5 cm-or-greater threshold, and the operative details supporting radical resection.
What is included in the global period?
The 90-day global period includes the preoperative visit on the day before surgery and 90 days of related postoperative care.
When can an assistant or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is 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.
2,97227613,,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
2,97627618,,Exc leg/ankle tum < 3 cm,A,,3.86,10.88,,4.29,,0.78,15.52,8.93,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97727619,,Exc leg/ankle tum deep <5 cm,A,,6.74,5.19,NA,5.19,,1.13,13.06,13.06,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97827620,,Explore/treat ankle joint,A,,6.00,6.01,NA,6.01,,1.03,13.04,13.04,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00