CPT code 27613: Soft-tissue biopsy, superficial leg or ankle2026 Medicare rate & RVUs in New York, New York

CPT 27613: $300.72–$308.51 office ($172.80–$177.85 facility) across 3 localities in New York, NY in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20263 payment localities

Medicare pays $300.72–$308.51 for 27613 in the office in New York, New York, from Manhattan, NY to NYC suburbs and Long Island, NY. Which amount applies depends on the service address.

$300.72–$308.51Office (non-facility)

$172.80–$177.85Hospital or facility

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

On this page 6 sections

Rate in New York, New York
By payment locality
City and payment areas
How it’s calculated
Payment rules
Sources

Where 27613 pays more and less in New York, New York

New York, New York maps to 3 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

3 payment localities

$300.72 to $308.51

One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

27613 office and facility rates by payment locality
Payment locality	Office	Facility
Manhattan, NY	$300.72	$173.03
NYC suburbs and Long Island, NY	$308.51	$177.85
Queens, NY	$302.69	$172.80

How payment areas work in New York

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

NYC suburbs / Long Island · Bronx County, Kings County, Richmond County
Manhattan · New York County
Queens · Queens County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 27613 rate is calculated

Each of 27613’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 · 27613

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work2.16

2.16 RVUs× 1.000 GPCI

Practice expense5.32

5.32 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

7.8100

Conversion factor

$33.4009

Medicare rate

$260.86

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

Payment rules and modifiers for 27613

27613 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27613

Soft-tissue biopsy, superficial leg or ankle

Rule	CMS value	What it means
Global period	010	Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures	2	Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)	1	Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)	1	Not paid (statutory restriction).
Co-surgeons (62)	0	Not permitted.
Team surgery (66)	0	Not permitted.
Professional/technical	0	Physician service: no professional/technical split.
Split (54/55/56)	0.10/0.80/0.10	Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27613

Soft-tissue biopsy, superficial leg or ankle

Date of surgery

Date of a later visit

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit

Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27613 without 50 · national office

$260.86

Soft-tissue biopsy, superficial leg or ankle

27613-50 · Bilateral: 150%

$391.29

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

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 27613PPRRVU2026_Oct_nonQPP.csv, line 2,972 (RVU26D)

2,96927607,,[CPT descriptor omitted],A,,8.40,6.93,NA,6.93,,1.65,16.98,16.98,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97027610,,[CPT descriptor omitted],A,,8.90,7.71,NA,7.71,,1.64,18.25,18.25,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97127612,,[CPT descriptor omitted],A,,7.95,7.01,NA,7.01,,1.25,16.21,16.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97227613,,[CPT descriptor omitted],A,,2.16,5.32,,2.03,,0.33,7.81,4.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97327614,,[CPT descriptor omitted],A,,5.66,11.69,,5.15,,0.92,18.27,11.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97427615,,[CPT descriptor omitted],A,,15.33,9.61,NA,9.61,,3.29,28.23,28.23,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

2,97527616,,[CPT descriptor omitted],A,,19.14,11.38,NA,11.38,,4.17,34.69,34.69,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Open CMS source How we calculate rates

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Where 27613 pays more and less in New York, New York

How payment areas work in New York

How the 27613 rate is calculated

Payment rules and modifiers for 27613

What modifiers do to the payment

Where these rates come from

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