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CPT code 27656: Fascia repair, lower leg2026 Medicare rate & RVUs in Iowa

Surgical repair of a defect in lower-leg fascia, such as a symptomatic muscle herniation through the fascial layer.

CMS RVU26DEffective Oct 1, 2026One payment locality200 Medicare services in 2024

In Iowa, Medicare pays $489.02 for 27656 in the office and $296.18 when it’s performed in a hospital or facility.

$489.02Office (non-facility)
$296.18Hospital or facility
−8.0%vs the national office rate ($531.74)

Check a contract rate as a % of Medicare · 27656 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 27656 for the payment locality that covers the ZIP.

On this page 10 sections
  1. Rate in Iowa
  2. What 27656 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Rate history
  8. Where it applies
  9. Billing questions
  10. Sources

What 27656 covers

This service repairs a gap in the lower-leg fascia, the connective tissue covering the muscles. A familiar clinical situation is a symptomatic muscle herniation that protrudes through a fascial defect. An orthopedic surgeon or another surgeon treating lower-leg soft-tissue conditions may perform the repair in an operating room or ambulatory surgery setting. The operative report should identify the defect’s location and describe the fascial repair performed.

Report this code for the fascia repair itself, not for repair of an Achilles, flexor, or extensor tendon. CMS assigns a 90-day global period: the day-before preoperative visit and related postoperative care during the 90 days are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; 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 Iowa compares for 27656

Across 109 of 109 payment localities, the office rate for 27656 runs from $471.37 in Arkansas to $697.41 in San Benito County, CA. Iowa pays $489.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

27656 in Iowa vs other payment areas
  1. Iowa · this page$489.02
  2. Los Angeles, CA · California$596.71+$107.69
  3. Washington, DC area · District of Columbia$606.06+$117.04
  4. Miami, FL · Florida$577.58+$88.56
  5. Chicago, IL · Illinois$560.99+$71.97
  6. Manhattan, NY · New York$611.50+$122.48
  7. Alaska · Alaska$622.52+$133.50

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

Every other payment area

27656 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$478.14$293.73
ArkansasArkansas$471.37$290.33
ArizonaArizona$517.71$313.48
Bakersfield, CACalifornia$561.06$330.07
Chico, CACalifornia$559.27$328.28
El Centro, CACalifornia$559.37$328.38
Fresno, CACalifornia$559.27$328.28
Hanford, CACalifornia$559.27$328.28

27656 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.

$471.37

$628.34

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

View every state and territory as a table
27656 office rate range by state
State / territoryOffice rate rangeLocalities
AK$622.521
AL$478.141
AR$471.371
AZ$517.711
CA$559.27–$697.4129
CO$552.041
CT$566.661
DC$606.061
DE$526.151
FL$526.24–$577.583
GA$496.98–$542.032
GU$572.221
HI$572.221
IA$489.021
ID$492.361
IL$512.06–$560.994
IN$495.131
KS$487.261
KY$490.271
LA$489.71–$513.392
MA$549.04–$605.252
MD$535.90–$606.063
ME$495.40–$521.002
MI$503.22–$533.192
MN$527.781
MO$481.80–$514.603
MS$476.651
MT$531.701
NC$500.401
ND$519.641
NE$491.501
NH$543.881
NJ$572.79–$600.082
NM$506.121
NV$528.701
NY$507.79–$626.695
OH$500.751
OK$488.891
OR$524.26–$568.722
PA$501.26–$553.112
PR$535.381
RI$544.271
SC$501.471
SD$518.211
TN$489.731
TX$498.07–$550.498
UT$508.181
VA$519.67–$606.062
VI$535.381
VT$518.101
WA$547.84–$616.962
WI$502.601
WV$493.621
WY$526.441

See 27656 in every payment locality

How the 27656 rate is calculated

Each of 27656’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 · 27656

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.59

4.59 RVUs× 1.000 GPCI

Practice expense10.72

10.72 RVUs× 1.000 GPCI

Malpractice0.61

0.61 RVUs× 1.000 GPCI

Adjusted RVUs

15.9200

Conversion factor

$33.4009

Medicare rate

$531.74

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,996

Code
27656
Physician work
4.59
Practice expense
10.72
Malpractice
0.61

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 27656 in Iowa
ComponentRVULocality factorAdjusted
Physician work4.59× 1.0004.5900
Practice expense10.72× 0.9159.8088
Malpractice0.61× 0.3970.2422
Total RVUs14.6410
Conversion factor× 33.4009

Office rate, Iowa$489.02

Office: (4.59 × 1 + 10.72 × 0.915 + 0.61 × 0.397) × $33.4009 = $489.02

Facility: (4.59 × 1 + 4.41 × 0.915 + 0.61 × 0.397) × $33.4009 = $296.18

Open 27656 in the RVU calculator

Payment rules and modifiers for 27656

27656 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27656

Fascia repair, lower leg

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)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 · 27656

Fascia repair, lower leg

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

27656 without 50 · national office

$531.74

Fascia repair, lower leg

27656-50 · Bilateral: 150%

$797.61

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

How 27656 has changed in Iowa

27656 · Office / nonfacility

$489.02

Effective 2026-10-01

The base rate is $21.11 higher than on 2025-10-01, moving from $467.91 to $489.02 (4.5%).

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

    $467.91changed to$489.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.71 changed to 4.59
    • Practice expense RVU 10.39 changed to 10.72
    • Malpractice RVU 0.59 changed to 0.61
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $487.61changed to$467.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.57 changed to 10.39
    • Malpractice RVU 0.63 changed to 0.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $479.65changed to$487.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $502.37changed to$479.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.80 changed to 10.57
    • Malpractice RVU 0.65 changed to 0.63
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $517.91changed to$502.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.97 changed to 10.80
    • Malpractice RVU 0.72 changed to 0.65
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $529.84changed to$517.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.23 changed to 10.97
    • Malpractice RVU 0.68 changed to 0.72

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $597.15changed to$529.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.62 changed to 11.23
    • Malpractice RVU 0.92 changed to 0.68
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $595.26changed to$597.15

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.57 changed to 12.62
    • Malpractice RVU 0.96 changed to 0.92
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $594.96changed to$595.26

    • Malpractice RVU 0.94 changed to 0.96

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $595.59changed to$594.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.60 changed to 12.57
    • Malpractice RVU 0.96 changed to 0.94

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $575.86changed to$595.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.09 changed to 12.60
    • Malpractice RVU 0.94 changed to 0.96
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $586.13changed to$575.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.48 changed to 12.09
    • Malpractice RVU 0.97 changed to 0.94
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $589.88changed to$586.13

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.52 changed to 12.48
    • Malpractice RVU 0.99 changed to 0.97

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $586.95changed to$589.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $577.84changed to$586.95

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.34 changed to 12.52
    • Malpractice RVU 0.87 changed to 0.99
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $588.11changed to$577.84

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.71 changed to 12.34
    • Malpractice RVU 0.91 changed to 0.87
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $588.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$489.02$296.18RVU26D
2026-07-01$489.02$296.18RVU26C
2026-04-01$489.02$296.18RVU26B
2026-01-01$489.02$296.18RVU26A
2025-10-01$467.91$310.80RVU25D
2025-07-01$467.91$310.80RVU25C
2025-04-01$467.91$310.80RVU25B
2025-01-01$467.91$310.80RVU25A
2024-10-01$487.61$319.54RVU24D
2024-07-01$487.61$319.54RVU24C
2024-04-01$487.61$319.54RVU24B
2024-03-09$487.61$319.54RVU24AR
2024-01-01$479.65$314.33RVU24A
2023-10-01$502.37$325.05RVU23D
2023-07-01$502.37$325.05RVU23C
2023-04-01$502.37$325.05RVU23B
2023-01-01$502.37$325.05RVU23A
2022-10-01$517.91$331.47RVU22D
2022-07-01$517.91$331.47RVU22C
2022-04-01$517.91$331.47RVU22B
2022-01-01$517.91$331.47RVU22A
2021-10-01$529.84$332.99RVU21D
2021-07-01$529.84$332.99RVU21C
2021-04-01$529.84$332.99RVU21B
2021-01-01$529.84$332.99RVU21A
2020-10-01$597.15$373.59RVU20D
2020-07-01$597.15$373.59RVU20C
2020-04-01$597.15$373.59RVU20B
2020-01-01$597.15$373.59RVU20A
2019-10-01$595.26$372.33RVU19D
2019-07-01$595.26$372.33RVU19C
2019-04-01$594.96$372.03RVU19B
2019-01-01$594.96$372.03RVU19A
2018-10-01$595.59$371.92RVU18D
2018-07-01$595.59$371.92RVU18C
2018-04-01$595.59$371.92RVU18B
2018-01-01$595.59$371.92RVU18AR1
2017-10-01$575.86$364.15RVU17D
2017-07-01$575.86$364.15RVU17C
2017-04-01$575.86$364.15RVU17B
2017-01-01$575.86$364.15RVU17A
2016-10-01$586.13$368.62RVU16D
2016-07-01$586.13$368.62RVU16C
2016-04-01$586.13$368.62RVU16B
2016-01-01$586.13$368.62RVU16A
2015-10-01$589.88$370.30RVU15D
2015-07-01$589.88$370.30RVU15C
2015-04-01$586.95$368.46RVU15B
2015-01-01$586.95$368.46RVU15A
2014-10-01$577.84$364.07RVU14D
2014-07-01$577.84$364.07RVU14C
2014-04-01$577.84$364.07RVU14B
2014-01-01$577.84$364.07RVU14A
2013-10-01$588.11$361.77RVU13D
2013-07-01$588.11$361.77RVU13C
2013-04-01$588.11$361.77RVU13B
2013-01-01$588.11$361.77RVU13AR

Price 27656 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

27656 billing questions

How is this different from a lower-leg tendon repair code?

This service repairs the fascia surrounding the lower-leg muscles. Use a tendon repair code when the operative service repairs a flexor, extensor, or Achilles tendon.

What documentation supports reporting this service?

Document the lower-leg fascial defect, its location, and the repair performed. If muscle herniation prompted surgery, describe that finding and its relationship to the defect.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and related postoperative care during the 90 days are included in the global period.

How is bilateral repair paid?

CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is at 150%.

Can an assistant surgeon be reported?

CMS indicates that assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted for this code.

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 27656PPRRVU2026_Oct_nonQPP.csv, line 2,996 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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