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

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 Virginia, Medicare pays $464.47 for 27604 in the office and $306.21 when it’s performed in a hospital or facility.

$464.47Office (non-facility)
$306.21Hospital or facility
−2.8%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 Virginia
  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 Virginia 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. Virginia pays $464.47. The RVUs are the same everywhere; the geographic indexes change the dollars.

27604 in Virginia vs other payment areas
  1. Virginia · this page$464.47
  2. Los Angeles, CA · California$529.58+$65.11
  3. Washington, DC area · District of Columbia$542.32+$77.85
  4. Miami, FL · Florida$531.84+$67.37
  5. Chicago, IL · Illinois$515.65+$51.18
  6. Manhattan, NY · New York$551.96+$87.49
  7. Alaska · Alaska$559.69+$95.22

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 27604 in Virginia
ComponentRVULocality factorAdjusted
Physician work4.48× 1.0004.4800
Practice expense9.00× 0.9838.8470
Malpractice0.82× 0.7060.5789
Total RVUs13.9059
Conversion factor× 33.4009

Office rate, Virginia$464.47

Office: (4.48 × 1 + 9 × 0.983 + 0.82 × 0.706) × $33.4009 = $464.47

Facility: (4.48 × 1 + 4.18 × 0.983 + 0.82 × 0.706) × $33.4009 = $306.21

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, Virginia
Used instead
27603Deep drainage, leg or ankle abscess/hematomaUse for drainage of a lower-leg lesion when the operative target is not a bursa.$529.89
20605Joint procedure, intermediate joint, no ultrasoundNeedle aspiration or injection for an intermediate joint or bursa, rather than open bursal drainage.$55.78
20610Joint injection, major joint or bursa, no ultrasoundNeedle aspiration or injection for a major joint or bursa, rather than open bursal drainage.$66.87

How 27604 has changed in Virginia

27604 · Office / nonfacility

$464.47

Effective 2026-10-01

The base rate is $25.06 higher than on 2025-10-01, moving from $439.41 to $464.47 (5.7%).

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

    $439.41changed to$464.47

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $441.82changed to$439.41

    • 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

    $434.61changed to$441.82

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $451.63changed to$434.61

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $459.65changed to$451.63

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $483.15changed to$459.65

    • 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

    $487.88changed to$483.15

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.39 changed to 8.69
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $485.42changed to$487.88

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $487.38changed to$485.42

    • 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

    $494.53changed to$487.38

    • 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
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $497.43changed to$494.53

    • 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 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $493.87changed to$497.43

    • 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

    $491.41changed to$493.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $459.86changed to$491.41

    • 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 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $484.04changed to$459.86

    • 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 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $484.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$464.47$306.21RVU26D
2026-07-01$464.47$306.21RVU26C
2026-04-01$464.47$306.21RVU26B
2026-01-01$464.47$306.21RVU26A
2025-10-01$439.41$320.05RVU25D
2025-07-01$439.41$320.05RVU25C
2025-04-01$439.41$320.05RVU25B
2025-01-01$439.41$320.05RVU25A
2024-10-01$441.82$318.34RVU24D
2024-07-01$441.82$318.34RVU24C
2024-04-01$441.82$318.34RVU24B
2024-03-09$441.82$318.34RVU24AR
2024-01-01$434.61$313.14RVU24A
2023-10-01$451.63$322.13RVU23D
2023-07-01$451.63$322.13RVU23C
2023-04-01$451.63$322.13RVU23B
2023-01-01$451.63$322.13RVU23A
2022-10-01$459.65$326.05RVU22D
2022-07-01$459.65$326.05RVU22C
2022-04-01$459.65$326.05RVU22B
2022-01-01$459.65$326.05RVU22A
2021-10-01$483.15$334.90RVU21D
2021-07-01$483.15$334.90RVU21C
2021-04-01$483.15$334.90RVU21B
2021-01-01$483.15$334.90RVU21A
2020-10-01$487.88$343.03RVU20D
2020-07-01$487.88$343.03RVU20C
2020-04-01$487.88$343.03RVU20B
2020-01-01$487.88$343.03RVU20A
2019-10-01$485.42$341.86RVU19D
2019-07-01$485.42$341.86RVU19C
2019-04-01$485.42$341.86RVU19B
2019-01-01$485.42$341.86RVU19A
2018-10-01$487.38$343.26RVU18D
2018-07-01$487.38$343.26RVU18C
2018-04-01$487.38$343.26RVU18B
2018-01-01$487.38$343.26RVU18AR1
2017-10-01$494.53$347.82RVU17D
2017-07-01$494.53$347.82RVU17C
2017-04-01$494.53$347.82RVU17B
2017-01-01$494.53$347.82RVU17A
2016-10-01$497.43$348.90RVU16D
2016-07-01$497.43$348.90RVU16C
2016-04-01$497.43$348.90RVU16B
2016-01-01$497.43$348.90RVU16A
2015-10-01$493.87$346.92RVU15D
2015-07-01$493.87$346.92RVU15C
2015-04-01$491.41$345.20RVU15B
2015-01-01$491.41$345.20RVU15A
2014-10-01$459.86$330.67RVU14D
2014-07-01$459.86$330.67RVU14C
2014-04-01$459.86$330.67RVU14B
2014-01-01$459.86$330.67RVU14A
2013-10-01$484.04$334.12RVU13D
2013-07-01$484.04$334.12RVU13C
2013-04-01$484.04$334.12RVU13B
2013-01-01$484.04$334.12RVU13AR

Price 27604 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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