27613 Biopsy lower leg soft tissue
What 27613 is
CMS fee schedule short descriptor: Biopsy lower leg soft tissue.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 27613 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.16 | 5.32 | 0.33 | 7.81 | $260.86 |
| Facility (hospital, ASC) | 2.16 | 2.03 | 0.33 | 4.52 | $150.97 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 10-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 27613 at 3 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 27613? These codes are bundled into it
27613 is a Column 1 code in 244 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01470 | Anes px nrv msc lw l/a/f nos | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
10005 | Fna bx w/us gdn 1st les | 1 - modifier may bypass | Check pair |
10007 | Fna bx w/fluor gdn 1st les | 1 - modifier may bypass | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 - modifier may bypass | Check pair |
10011 | Fna bx w/mr gdn 1st les | 1 - modifier may bypass | Check pair |
10021 | Fna bx w/o img gdn 1st les | 1 - modifier may bypass | Check pair |
10030 | Img gid flu coll drg sft tis | 1 - modifier may bypass | Check pair |
10060 | I&d abscess simple/single | 1 - modifier may bypass | Check pair |
10140 | I&d hmtma seroma/fluid collj | 1 - modifier may bypass | Check pair |
10160 | Pnxr aspir absc hmtma bulla | 1 - modifier may bypass | Check pair |
11010 | Debride skin at fx site | 1 - modifier may bypass | Check pair |
11011 | Debride skin musc at fx site | 1 - modifier may bypass | Check pair |
11012 | Deb skin bone at fx site | 1 - modifier may bypass | Check pair |
11900 | Inject skin lesions </w 7 | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
Showing 30 of 244 column 2 codes. Use the pair checker for any specific combination.
27613 is bundled into these codes
27613 appears as a Column 2 code in 34 active edits. Reported with one of these Column 1 codes on the same date of service, 27613 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
27607 | Treat lower leg bone lesion | 1 | Check pair |
27610 | Explore/treat ankle joint | 1 | Check pair |
27612 | Exploration of ankle joint | 1 | Check pair |
27614 | Biopsy lower leg soft tissue | 1 | Check pair |
27615 | Resect leg/ankle tum < 5 cm | 1 | Check pair |
27616 | Resect leg/ankle tum 5 cm/> | 1 | Check pair |
27618 | Exc leg/ankle tum < 3 cm | 1 | Check pair |
27619 | Exc leg/ankle tum deep <5 cm | 1 | Check pair |
27620 | Explore/treat ankle joint | 1 | Check pair |
27630 | Removal of tendon lesion | 1 | Check pair |
27632 | Exc leg/ankle les sc 3 cm/> | 1 | Check pair |
27634 | Exc leg/ankle tum dep 5 cm/> | 1 | Check pair |
27635 | Remove lower leg bone lesion | 1 | Check pair |
27640 | Partial removal of tibia | 1 | Check pair |
27641 | Partial removal of fibula | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.