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CPT code 27604: Bursa drainage, lower leg or ankle2026 Medicare rate & RVUs in North Carolina

Reports operative incision and drainage of a bursa in the lower leg or ankle, such as when a bursal collection requires open treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality111 Medicare services in 2024

In North Carolina, Medicare pays $447.60 for 27604 in the office and $297.40 when it’s performed in a hospital or facility.

$447.60Office (non-facility)
$297.40Hospital or facility
−6.3%vs the national office rate ($477.63)

Check a contract rate as a % of Medicare · 27604 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 27604 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 27604 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 27604 covers

An orthopedic or foot and ankle surgeon uses an incision to drain a bursa in the lower leg or ankle. The service is appropriate when the operative target is the bursa itself, rather than a separate soft-tissue lesion or the ankle joint. Documentation should identify the bursa and site, the reason open drainage was performed, and the operative work and findings.

Report this service for the bursal drainage, not for needle aspiration alone. The CMS global period is 90 days, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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.

How North Carolina compares for 27604

Across 109 of 109 payment localities, the office rate for 27604 runs from $421.96 in Arkansas to $614.25 in San Benito County, CA. North Carolina pays $447.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

27604 in North Carolina vs other payment areas
  1. North Carolina · this page$447.60
  2. Los Angeles, CA · California$529.58+$81.98
  3. Washington, DC area · District of Columbia$542.32+$94.72
  4. Miami, FL · Florida$531.84+$84.24
  5. Chicago, IL · Illinois$515.65+$68.05
  6. Manhattan, NY · New York$551.96+$104.36
  7. Alaska · Alaska$559.69+$112.09

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

27604 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$428.17$287.30
ArkansasArkansas$421.96$283.67
ArizonaArizona$464.37$308.37
Bakersfield, CACalifornia$498.63$322.18
Chico, CACalifornia$496.33$319.88
El Centro, CACalifornia$496.46$320.02
Fresno, CACalifornia$496.33$319.88
Hanford, CACalifornia$496.33$319.88

27604 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$421.96

$559.69

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
27604 office rate range by state
State / territoryOffice rate rangeLocalities
AK$559.691
AL$428.171
AR$421.961
AZ$464.371
CA$496.33–$614.2529
CO$492.671
CT$509.521
DC$542.321
DE$472.011
FL$478.18–$531.843
GA$450.43–$488.402
GU$507.291
HI$507.291
IA$435.571
ID$439.151
IL$466.90–$515.654
IN$441.611
KS$435.191
KY$441.941
LA$441.91–$463.622
MA$490.40–$539.072
MD$480.49–$542.323
ME$443.23–$464.822
MI$455.01–$485.902
MN$467.071
MO$435.44–$463.263
MS$428.701
MT$477.581
NC$447.601
ND$461.361
NE$437.451
NH$486.531
NJ$513.93–$537.022
NM$458.191
NV$473.361
NY$454.47–$567.505
OH$451.701
OK$439.361
OR$468.30–$506.382
PA$451.48–$497.942
PR$480.531
RI$487.441
SC$450.681
SD$459.451
TN$437.601
TX$448.63–$492.258
UT$456.801
VA$464.47–$542.322
VI$480.531
VT$461.101
WA$488.96–$548.342
WI$446.051
WV$450.061
WY$470.511

See 27604 in every payment locality

How the 27604 rate is calculated

Each of 27604’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 · 27604

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.48

4.48 RVUs× 1.000 GPCI

Practice expense9.00

9.00 RVUs× 1.000 GPCI

Malpractice0.82

0.82 RVUs× 1.000 GPCI

Adjusted RVUs

14.3000

Conversion factor

$33.4009

Medicare rate

$477.63

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,966

Code
27604
Physician work
4.48
Practice expense
9.00
Malpractice
0.82

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 27604 in North Carolina
ComponentRVULocality factorAdjusted
Physician work4.48× 1.0004.4800
Practice expense9.00× 0.9338.3970
Malpractice0.82× 0.6390.5240
Total RVUs13.4010
Conversion factor× 33.4009

Office rate, North Carolina$447.60

Office: (4.48 × 1 + 9 × 0.933 + 0.82 × 0.639) × $33.4009 = $447.60

Facility: (4.48 × 1 + 4.18 × 0.933 + 0.82 × 0.639) × $33.4009 = $297.40

Open 27604 in the RVU calculator

Payment rules and modifiers for 27604

27604 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27604

Bursa drainage, lower leg or ankle

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27604

Bursa drainage, lower leg or ankle

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27604 without 50 · national office

$477.63

Bursa drainage, lower leg or ankle

27604-50 · Bilateral: 150%

$716.45

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).

When to use modifier 50

Codes related to 27604

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27604
CodeHow it relatesOffice range, North Carolina
Used instead
27603Deep drainage, leg or ankle abscess/hematomaUse for drainage of a lower-leg lesion when the operative target is not a bursa.$510.65
20605Joint procedure, intermediate joint, no ultrasoundNeedle aspiration or injection for an intermediate joint or bursa, rather than open bursal drainage.$53.98
20610Joint injection, major joint or bursa, no ultrasoundNeedle aspiration or injection for a major joint or bursa, rather than open bursal drainage.$64.64

How 27604 has changed in North Carolina

27604 · Office / nonfacility

$447.60

Effective 2026-10-01

The base rate is $26.81 higher than on 2025-10-01, moving from $420.79 to $447.60 (6.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $420.79changed to$447.60

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.59 changed to 4.48
    • Practice expense RVU 8.51 changed to 9.00
    • Malpractice RVU 0.81 changed to 0.82
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $423.42changed to$420.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.27 changed to 8.51
    • Malpractice RVU 0.71 changed to 0.81

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $416.51changed to$423.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $432.05changed to$416.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.25 changed to 8.27
    • Malpractice RVU 0.69 changed to 0.71
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $439.00changed to$432.05

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.15 changed to 8.25
    • Malpractice RVU 0.65 changed to 0.69
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $460.98changed to$439.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.69 changed to 8.15
    • Malpractice RVU 0.68 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $465.83changed to$460.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.39 changed to 8.69
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $463.54changed to$465.83

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.37 changed to 8.39
    • Malpractice RVU 0.69 changed to 0.68
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $465.37changed to$463.54

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.44 changed to 8.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $474.12changed to$465.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.67 changed to 8.44
    • Malpractice RVU 0.75 changed to 0.69
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $479.15changed to$474.12

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.81 changed to 8.67
    • Malpractice RVU 0.78 changed to 0.75
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $475.80changed to$479.15

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.65 changed to 8.81
    • Malpractice RVU 0.79 changed to 0.78

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $473.44changed to$475.80

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $444.34changed to$473.44

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.82 changed to 8.65
    • Malpractice RVU 0.75 changed to 0.79
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $467.29changed to$444.34

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.28 changed to 7.82
    • Malpractice RVU 0.78 changed to 0.75
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $467.29

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$447.60$297.40RVU26D
2026-07-01$447.60$297.40RVU26C
2026-04-01$447.60$297.40RVU26B
2026-01-01$447.60$297.40RVU26A
2025-10-01$420.79$308.47RVU25D
2025-07-01$420.79$308.47RVU25C
2025-04-01$420.79$308.47RVU25B
2025-01-01$420.79$308.47RVU25A
2024-10-01$423.42$307.22RVU24D
2024-07-01$423.42$307.22RVU24C
2024-04-01$423.42$307.22RVU24B
2024-03-09$423.42$307.22RVU24AR
2024-01-01$416.51$302.20RVU24A
2023-10-01$432.05$310.80RVU23D
2023-07-01$432.05$310.80RVU23C
2023-04-01$432.05$310.80RVU23B
2023-01-01$432.05$310.80RVU23A
2022-10-01$439.00$314.39RVU22D
2022-07-01$439.00$314.39RVU22C
2022-04-01$439.00$314.39RVU22B
2022-01-01$439.00$314.39RVU22A
2021-10-01$460.98$322.72RVU21D
2021-07-01$460.98$322.72RVU21C
2021-04-01$460.98$322.72RVU21B
2021-01-01$460.98$322.72RVU21A
2020-10-01$465.83$329.89RVU20D
2020-07-01$465.83$329.89RVU20C
2020-04-01$465.83$329.89RVU20B
2020-01-01$465.83$329.89RVU20A
2019-10-01$463.54$327.98RVU19D
2019-07-01$463.54$327.98RVU19C
2019-04-01$463.54$327.98RVU19B
2019-01-01$463.54$327.98RVU19A
2018-10-01$465.37$329.30RVU18D
2018-07-01$465.37$329.30RVU18C
2018-04-01$465.37$329.30RVU18B
2018-01-01$465.37$329.30RVU18AR1
2017-10-01$474.12$335.46RVU17D
2017-07-01$474.12$335.46RVU17C
2017-04-01$474.12$335.46RVU17B
2017-01-01$474.12$335.46RVU17A
2016-10-01$479.15$338.63RVU16D
2016-07-01$479.15$338.63RVU16C
2016-04-01$479.15$338.63RVU16B
2016-01-01$479.15$338.63RVU16A
2015-10-01$475.80$336.78RVU15D
2015-07-01$475.80$336.78RVU15C
2015-04-01$473.44$335.11RVU15B
2015-01-01$473.44$335.11RVU15A
2014-10-01$444.34$321.87RVU14D
2014-07-01$444.34$321.87RVU14C
2014-04-01$444.34$321.87RVU14B
2014-01-01$444.34$321.87RVU14A
2013-10-01$467.29$325.05RVU13D
2013-07-01$467.29$325.05RVU13C
2013-04-01$467.29$325.05RVU13B
2013-01-01$467.29$325.05RVU13AR

Price 27604 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

27604 billing questions

How is this different from 27603?

Choose 27604 when the operative target is a bursa in the lower leg or ankle. Code 27603 describes drainage of a lower-leg lesion rather than a bursa.

Can needle aspiration of a bursa be reported as 27604?

No. 27604 describes operative incision and drainage; needle aspiration is a different service. Codes 20605 or 20610 may be relevant for aspiration or injection, depending on the bursa and site.

What should the operative note support?

Document the bursa and anatomic site, the indication for open drainage, and the incision, drainage, and operative findings. The record should make clear that the bursa, rather than an adjacent lesion or joint, was treated.

How does modifier 50 affect payment?

CMS identifies this as a bilateral procedure; reporting modifier 50 results in payment at 150%.

What are the assistant and global-surgery rules?

Assistant-at-surgery payment is allowed only when medical necessity is documented. The 90-day global period includes the day-before preoperative visit and related postoperative care; co-surgeons and team surgery are 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
RVUs for 27604PPRRVU2026_Oct_nonQPP.csv, line 2,966 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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