Question: The surgeon removed a ganglion cyst that was over the sinus tarsi area of the patient's foot. For the facility, should I report 27630 if he made a subcutaneous incision?
Answer: Although 27630 (Excision of lesion of tendon sheath or capsule [e.g., cyst or ganglion], leg and/or ankle) is a valid code for a freestanding or hospital-based facility, it's not your best choice in this situation. Because the cyst was on the patient's foot, choose 28090 (Excision of lesion, tendon, tendon sheath, or capsule [including synovectomy] [e.g., cyst or ganglion]; foot). If you're coding for a freestanding facility, the national facility rate for 28090 is $891.60, and the procedure falls under payment indicator A2 (Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight). For hospital-based OPPS coding, procedure 28090 is under APC classification 0055 (Level I foot musculoskeletal procedures). [...]