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Official Description

Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 27630 refers to the excision of a lesion located within the tendon sheath or joint capsule, specifically in the leg and/or ankle region. Common lesions that may necessitate this procedure include cysts and ganglia. Cysts are fluid-filled sacs that can develop in various tissues, while ganglia are a specific type of cyst that is multiloculated, meaning they contain multiple compartments filled with fluid, and typically arise from fibrous tissue. These lesions are generally benign, meaning they are not cancerous. However, they may cause significant discomfort or pain, particularly when the patient is standing or walking, which can lead to the decision to remove them. The surgical approach for excision is determined by the precise location of the lesion. During the procedure, a surgical incision is made in the skin, and the incision is extended through the underlying soft tissues with careful attention to preserving nearby nerves and blood vessels. Once the tendon sheath or joint capsule is adequately exposed, the surgeon identifies the cyst and meticulously dissects it away from the surrounding tendon sheath or capsule before removing it entirely. Finally, the incision is closed in layers to promote proper healing and minimize scarring.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The excision of a lesion of the tendon sheath or capsule, as described by CPT® Code 27630, is indicated in the following scenarios:

  • Cysts - Fluid-filled sacs that may cause discomfort or pain.
  • Ganglia - Multiloculated cysts that arise from fibrous tissue and can lead to significant symptoms when located in the leg or ankle.
  • Significant Discomfort - Lesions that result in pain or discomfort during activities such as standing or walking.

2. Procedure

The procedure for excising a lesion of the tendon sheath or capsule involves several critical steps:

  • Step 1: Incision - The surgeon begins by making an incision in the skin over the area where the lesion is located. This incision is carefully planned to provide optimal access to the lesion while minimizing damage to surrounding tissues.
  • Step 2: Dissection - After the initial incision, the surgeon proceeds to dissect through the soft tissues. This step requires meticulous attention to detail to protect nearby nerves and vascular structures that may be present in the area.
  • Step 3: Exposure of the Lesion - Once the soft tissues are adequately dissected, the tendon sheath or joint capsule is exposed. The surgeon then identifies the cyst or ganglion that needs to be excised.
  • Step 4: Lesion Removal - The cyst is carefully dissected free from the tendon sheath or capsule. This step is crucial to ensure that the lesion is completely removed without damaging the surrounding structures.
  • Step 5: Closure - After the lesion has been excised, the incision is closed in a layered fashion. This technique helps to promote proper healing and reduces the risk of complications such as infection or excessive scarring.

3. Post-Procedure

Post-procedure care following the excision of a lesion of the tendon sheath or capsule typically involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised to keep the area clean and dry, and to follow any specific instructions provided by the surgeon regarding activity restrictions. Pain management may be necessary, and patients should be informed about the expected recovery timeline, which can vary based on individual healing processes and the extent of the surgery performed. Follow-up appointments may be scheduled to assess healing and address any concerns that may arise during the recovery period.

Short Descr REMOVAL OF TENDON LESION
Medium Descr EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
Long Descr Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 2
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
T2 Left foot, third digit
T8 Right foot, fourth digit
TA Left foot, great toe
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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