CPT Code 27043
CPT code 27043 is used to describe an excision of a lesion in the hip or pelvis that is 3 cm or smaller.
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What is CPT Code 27043
CPT code 27043 is used to describe the excision of a lesion from the hip or pelvis area that measures greater than 3 centimeters. This procedure involves the surgical removal of the lesion, which may be necessary for diagnostic purposes or to treat a condition affecting the hip or pelvic region. The code indicates that the excision is significant in size, requiring specific surgical techniques and considerations.
Does CPT 27043 Need a Modifier?
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CPT Code 27043 Medicare Reimbursement
CPT code 27043 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and their corresponding reimbursement rates, which are updated annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for CPT code 27043. It is essential for healthcare providers to consult both the MPFS and their respective MAC to ensure compliance with Medicare's reimbursement criteria for this specific code.
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