CPT code 27612: Ankle exploration, open joint exploration2026 Medicare rate & RVUs

Medicare pays $541.43 for 27612 nationally in a facility.

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

What 27612 covers

Ankle joint exploration uses an open surgical approach to expose and inspect the joint. Orthopedic surgeons, including foot and ankle specialists, may perform it in an operating room when examination or imaging has not established the source of an intra-articular problem, or when direct inspection is needed during surgery. The operative report should identify the ankle joint explored, the reason for exploration, the approach, and the findings or actions taken.

Select this code when the documented service supports ankle joint exploration, rather than a more specific procedure such as removal of joint lining or biopsy of a lower-leg soft-tissue mass. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, payment is 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 27612 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27612 rates by state

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

How the 27612 rate is calculated

Each of 27612’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.

Payment rules and modifiers for 27612

27612 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27612 compared with similar codes

How to choose

27610Ankle arthrotomyExploration, drainage, or foreign body

Both concern ankle arthrotomy services. Choose based on the procedure actually documented and the complete CPT descriptor, rather than the shared ankle-joint context.

27620Ankle arthrotomyWith or without biopsy

This is another ankle joint exploration or treatment code. The operative details and the complete descriptor determine which code fits.

27625Ankle synovectomyStandard extent

Use the synovectomy code when the surgeon removes ankle joint lining; exploration alone is distinct from that tissue-removal work.

27613Soft-tissue biopsySuperficial leg or ankle

This code concerns biopsy of lower-leg soft tissue. It is not the ankle joint exploration code when the target is intra-articular.

Codes related to 27612

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

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

Open CMS sourceHow we calculate rates