Billing code 27616: Tumor resectionMedicare rate & RVUs in Washington
Reports radical removal of a soft-tissue tumor in the leg or ankle area when the tumor measures 5 cm or greater.
CMS doesn’t publish an office rate for 27616 in Washington.
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 27616 covers
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.
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 27616 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,153.85 |
| Seattle (King Cnty) | Unavailable | $1,251.44 |
How the 27616 rate is calculated
Each of 27616’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 · 27616
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.14Practice expense 11.38Malpractice 4.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27616
27616 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27616
Tumor resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27616
Tumor resection
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27616 without 50 · national facility
$1,158.68
Tumor resection
27616-50 · Bilateral: 150%
$1,738.02
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).
27616 compared with similar codes
Compare codes
27616 vs 27615 vs 27634 vs 27613: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27615Tumor resection
- This is the size sibling for radical resection: 27616 applies at 5 cm or greater; 27615 applies below 5 cm.
- 27634Soft-tissue excision
- 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.
- 27613Soft-tissue biopsy
- 27613 is for diagnostic soft-tissue biopsy in the lower-leg or ankle area. 27616 is for definitive radical removal of a qualifying tumor.
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 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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