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CPT code 27648: Arthrogram injection, ankle joint2026 Medicare rate & RVUs in Puerto Rico

Reports intra-articular contrast injection into the ankle to prepare for arthrographic imaging when clinicians need to evaluate joint structures.

CMS RVU26DEffective Oct 1, 2026One payment locality414 Medicare services in 2024

In Puerto Rico, Medicare pays $208.56 for 27648 in the office and $43.77 when it’s performed in a hospital or facility.

$208.56Office (non-facility)
$43.77Hospital or facility
+0.9%vs the national office rate ($206.75)

Check a contract rate as a % of Medicare · 27648 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 27648 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 27648 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 27648 covers

A physician, commonly a radiologist, places a needle or catheter into the ankle joint and injects contrast for an arthrogram. The injection precedes imaging used to assess the joint, such as radiography, CT, or MRI. Ankle arthrography may be requested to evaluate suspected cartilage or ligament injury, joint-surface abnormalities, or persistent symptoms after an ankle injury.

Select this code for the ankle-joint injection, not for an injection into another joint or for the imaging acquisition and interpretation. The record should identify the ankle, the clinical indication, and the intra-articular contrast injection. Report the imaging service separately when performed and documented; ankle arthrography imaging may be reported with 73615. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and 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 Puerto Rico compares for 27648

Across 109 of 109 payment localities, the office rate for 27648 runs from $180.42 in Arkansas to $283.48 in San Benito County, CA. Puerto Rico pays $208.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

27648 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$208.56
  2. Los Angeles, CA · California$237.70+$29.14
  3. Washington, DC area · District of Columbia$239.36+$30.80
  4. Miami, FL · Florida$220.90+$12.34
  5. Chicago, IL · Illinois$213.88+$5.32
  6. Manhattan, NY · New York$239.15+$30.59
  7. Alaska · Alaska$231.44+$22.88

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

27648 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$183.39$40.77
ArkansasArkansas$180.42$40.40
ArizonaArizona$200.79$42.84
Bakersfield, CACalifornia$221.90$43.26
Chico, CACalifornia$221.50$42.86
El Centro, CACalifornia$221.52$42.88
Fresno, CACalifornia$221.50$42.86
Hanford, CACalifornia$221.50$42.86

27648 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.

$180.42

$252.49

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

View every state and territory as a table
27648 office rate range by state
State / territoryOffice rate rangeLocalities
AK$231.441
AL$183.391
AR$180.421
AZ$200.791
CA$221.50–$283.4829
CO$217.031
CT$221.501
DC$239.361
DE$204.391
FL$201.59–$220.903
GA$189.22–$210.522
GU$228.171
HI$228.171
IA$189.421
ID$190.631
IL$194.54–$215.194
IN$191.891
KS$188.051
KY$187.411
LA$186.93–$197.322
MA$215.35–$240.642
MD$208.73–$239.363
ME$191.33–$203.492
MI$192.51–$203.992
MN$208.411
MO$183.08–$198.573
MS$181.811
MT$206.741
NC$193.631
ND$203.971
NE$190.701
NH$213.161
NJ$224.16–$236.362
NM$193.531
NV$206.141
NY$196.83–$245.035
OH$191.941
OK$187.451
OR$204.68–$225.002
PA$192.50–$215.222
PR$208.561
RI$212.481
SC$193.081
SD$203.651
TN$189.051
TX$191.06–$216.188
UT$196.031
VA$202.48–$239.362
VI$208.561
VT$202.731
WA$215.09–$246.212
WI$196.351
WV$186.411
WY$205.541

See 27648 in every payment locality

How the 27648 rate is calculated

Each of 27648’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 · 27648

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.94

0.94 RVUs× 1.000 GPCI

Practice expense5.11

5.11 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

6.1900

Conversion factor

$33.4009

Medicare rate

$206.75

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,992

Code
27648
Physician work
0.94
Practice expense
5.11
Malpractice
0.14

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 27648 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.94× 1.0000.9400
Practice expense5.11× 1.0115.1662
Malpractice0.14× 0.9850.1379
Total RVUs6.2441
Conversion factor× 33.4009

Office rate, Puerto Rico$208.56

Office: (0.94 × 1 + 5.11 × 1.011 + 0.14 × 0.985) × $33.4009 = $208.56

Facility: (0.94 × 1 + 0.23 × 1.011 + 0.14 × 0.985) × $33.4009 = $43.77

Open 27648 in the RVU calculator

Payment rules and modifiers for 27648

The CMS indicators that decide how 27648 is paid alongside other services.

CMS payment indicators · 27648

Arthrogram injection, ankle joint

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27648 without 50 · national office

$206.75

Arthrogram injection, ankle joint

27648-50 · Bilateral: 150%

$310.13

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 27648

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

Codes related to 27648
CodeHow it relatesOffice range, Puerto Rico
Often billed with
73615Ankle arthrography, radiographic supervision and interpretationReports radiographic ankle arthrography supervision and interpretation associated with the injection.$134.16
73722Joint MRI, with contrastMRI of a lower-extremity joint with contrast may follow the ankle-joint injection.$317.76
Same family
27093Hip arthrogram injection, without anesthesiaArthrography injection code for the hip rather than the ankle.$234.43

How 27648 has changed in Puerto Rico

27648 · Office / nonfacility

$208.56

Effective 2026-10-01

The base rate is $9.23 higher than on 2025-10-01, moving from $199.33 to $208.56 (4.6%).

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

    $199.33changed to$208.56

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.96 changed to 0.94
    • Practice expense RVU 5.02 changed to 5.11
    • Malpractice RVU 0.15 changed to 0.14
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $211.84changed to$199.33

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.23 changed to 5.02
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $208.39changed to$211.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $220.65changed to$208.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.39 changed to 5.23
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $219.25changed to$220.65

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $230.92changed to$219.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.55 changed to 5.39
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $228.60changed to$230.92

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.41 changed to 5.55
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $208.08changed to$228.60

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.64 changed to 5.41
    • Malpractice RVU 0.13 changed to 0.14
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $189.12changed to$208.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.13 changed to 4.64
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $172.96changed to$189.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.69 changed to 4.13

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $148.66changed to$172.96

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.62 changed to 3.69
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $126.10changed to$148.66

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.58 changed to 3.62
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $125.44changed to$126.10

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.54 changed to 3.58
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $124.81changed to$125.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $122.96changed to$124.81

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.53 changed to 3.54
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $123.41changed to$122.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.89 changed to 3.53
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $123.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$208.56$43.77RVU26D
2026-07-01$208.56$43.77RVU26C
2026-04-01$208.56$43.77RVU26B
2026-01-01$208.56$43.77RVU26A
2025-10-01$199.33$49.82RVU25D
2025-07-01$199.33$49.82RVU25C
2025-04-01$199.33$49.82RVU25B
2025-01-01$199.33$49.82RVU25A
2024-10-01$211.84$50.95RVU24D
2024-07-01$211.84$50.95RVU24C
2024-04-01$211.84$50.95RVU24B
2024-03-09$211.84$50.95RVU24AR
2024-01-01$208.39$50.11RVU24A
2023-10-01$220.65$51.22RVU23D
2023-07-01$219.25$51.17RVU23C
2023-04-01$219.25$51.17RVU23B
2023-01-01$219.25$51.17RVU23A
2022-10-01$230.92$51.97RVU22D
2022-07-01$230.92$51.97RVU22C
2022-04-01$230.92$51.97RVU22B
2022-01-01$230.92$51.97RVU22A
2021-10-01$228.60$53.44RVU21D
2021-07-01$228.60$53.44RVU21C
2021-04-01$228.60$53.44RVU21B
2021-01-01$228.60$53.44RVU21A
2020-10-01$208.08$54.92RVU20D
2020-07-01$208.08$54.92RVU20C
2020-04-01$208.08$54.92RVU20B
2020-01-01$208.08$54.92RVU20A
2019-10-01$189.12$54.84RVU19D
2019-07-01$189.12$54.84RVU19C
2019-04-01$189.12$54.84RVU19B
2019-01-01$189.12$54.84RVU19A
2018-10-01$172.96$54.78RVU18D
2018-07-01$172.96$54.78RVU18C
2018-04-01$172.96$54.78RVU18B
2018-01-01$172.96$54.78RVU18AR1
2017-10-01$148.66$50.66RVU17D
2017-07-01$148.66$50.66RVU17C
2017-04-01$148.66$50.66RVU17B
2017-01-01$148.66$50.66RVU17A
2016-10-01$126.10$46.59RVU16D
2016-07-01$126.10$46.59RVU16C
2016-04-01$126.10$46.59RVU16B
2016-01-01$126.10$46.59RVU16A
2015-10-01$125.44$46.40RVU15D
2015-07-01$125.44$46.40RVU15C
2015-04-01$124.81$46.17RVU15B
2015-01-01$124.81$46.17RVU15A
2014-10-01$122.96$46.12RVU14D
2014-07-01$122.96$46.12RVU14C
2014-04-01$122.96$46.12RVU14B
2014-01-01$122.96$46.12RVU14A
2013-10-01$123.41$44.29RVU13D
2013-07-01$123.41$44.29RVU13C
2013-04-01$123.41$44.29RVU13B
2013-01-01$123.41$44.29RVU13AR

Price 27648 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

27648 billing questions

How is 27648 different from 73615?

27648 reports injection of contrast into the ankle joint. Code 73615 reports the radiographic arthrogram examination and its supervision and interpretation.

Can the ankle MRI be reported with the injection?

Yes, when an MRI is performed and documented, report the applicable MRI service separately. Code 73722 describes MRI of a lower-extremity joint with contrast.

Does this code apply to a knee or hip arthrogram?

No. This code is specific to the ankle joint; 27370 describes injection for knee arthrography, and 27093 describes injection for hip arthrography.

What documentation supports reporting 27648?

Document the ankle joint treated, the indication, and that contrast was injected intra-articularly to prepare for arthrographic imaging.

How is a bilateral ankle procedure reported?

Use modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.

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 27648PPRRVU2026_Oct_nonQPP.csv, line 2,992 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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