CPT code 27620: Ankle arthrotomy, with or without biopsy2026 Medicare rate & RVUs in Michigan

Open ankle-joint exploration, with or without biopsy, is reported when the surgeon surgically inspects the joint to evaluate intra-articular disease.

CMS RVU26DEffective Oct 1, 20262 payment localities523 Medicare services in 2024

CMS doesn’t publish an office rate for 27620 in Michigan.

—Office (non-facility)
$422.52–$452.12Hospital 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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Michigan
  2. What 27620 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 27620 covers

This procedure opens the ankle joint so the surgeon can inspect its structures and, when indicated, obtain a tissue sample. Orthopedic surgeons typically perform it in an operating room to investigate an intra-articular problem, such as suspected infection or inflammatory disease, when direct visualization or joint-tissue biopsy is needed. The biopsy is part of the described service; laboratory or pathology interpretation is a separate service when performed by another provider.

Select the code when the operative report supports an ankle arthrotomy for joint exploration, with or without biopsy. Document the reason for exploration, the joint entered, findings, and any specimen obtained. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services 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 27620 pays more and less in Michigan

27620 office and facility rates by payment locality
Payment localityOfficeFacility
Detroit, MIUnavailable$452.12
Rest of MichiganUnavailable$422.52

How the 27620 rate is calculated

Each of 27620’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 · 27620

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.00

6.00 RVUs× 1.000 GPCI

Practice expense6.01

6.01 RVUs× 1.000 GPCI

Malpractice1.03

1.03 RVUs× 1.000 GPCI

Adjusted RVUs

13.0400

Conversion factor

$33.4009

Medicare rate

$435.55

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

Payment rules and modifiers for 27620

27620 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27620

Ankle arthrotomy, with or without biopsy

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 27620

Ankle arthrotomy, with or without biopsy

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

27620 without 50 · national facility

$435.55

Ankle arthrotomy, with or without biopsy

27620-50 · Bilateral: 150%

$653.33

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

27620 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27620

    Ankle arthrotomy, with or without biopsy6 wRVU

    Not priced

  • 27610

    Ankle arthrotomy, exploration, drainage, or foreign body8.9 wRVU

    Not priced

  • 27625

    Ankle synovectomy, standard extent8.28 wRVU

    Not priced

  • 27626

    Ankle synovectomy, extensive synovectomy8.87 wRVU

    Not priced

How to choose

27610Ankle arthrotomyExploration, drainage, or foreign body
Choose 27620 for open ankle-joint exploration, with or without biopsy. Choose 27610 when the documented arthrotomy includes drainage or removal of a loose or foreign body.
27625Ankle synovectomyStandard extent
27625 is for ankle synovectomy when removal of synovial lining is the main procedure; 27620 is for joint exploration, with biopsy optional.
27626Ankle synovectomyExtensive synovectomy
27626 describes extensive ankle synovectomy. It is distinguished from 27620 by the operative focus on extensive synovial tissue removal rather than exploration.

27620 billing questions

How is this different from 27610?

27620 describes ankle arthrotomy for joint exploration, with or without biopsy. Use 27610 when the documented service is the arthrotomy involving exploration, drainage, or removal of a loose or foreign body.

Is the joint biopsy separately reported?

The biopsy is included in 27620 when performed as part of the joint exploration. The pathology interpretation is a separate service when performed and reported by the appropriate provider.

What documentation supports 27620?

Document the clinical reason for open exploration, the ankle joint entered, operative findings, and whether tissue was collected. The record should establish joint exploration rather than a procedure focused on synovectomy or removal of a loose body.

Can 27620 be reported for both ankles?

For a bilateral procedure, CMS payment uses modifier 50 and is 150% of the single-procedure amount. The operative documentation should support work on both ankle joints.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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 27620PPRRVU2026_Oct_nonQPP.csv, line 2,978 (RVU26D)

Open CMS sourceHow we calculate rates

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