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Billing code 27356: Bone lesion surgeryMedicare rate & RVUs

Reports curettage or excision of a benign femoral bone lesion when the resulting cavity is filled with autologous bone graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities77 Medicare services in 2024

Medicare pays $696.74 for 27356 nationally in a facility.

Medicare rate · 27356

Bone lesion surgery

Work RVUs
9.84
Total RVUs
20.86
Global days
090

National rate · 2026

$696.74

Facility setting, before claim adjustments.

See every locality for 27356 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 27356 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27356 covers

An orthopedic surgeon uses this service to remove or curette a benign bone cyst or tumor in the femur and fill the resulting defect with the patient’s own bone graft. The work is typically performed in an operating room when the lesion requires operative treatment; graft procurement is included in this code. The operative report should identify the femoral lesion, describe its removal or curettage, and document placement of autograft.

Select this code when autograft is used, rather than the related code for treatment without graft, allograft, or internal fixation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 may be made; 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 27356 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

27356 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$629.16
Alaska*Unavailable$849.12
ArizonaUnavailable$677.44
ArkansasUnavailable$620.83
AtlantaUnavailable$716.53
AustinUnavailable$706.74
BakersfieldUnavailable$704.33
Baltimore/Surr. CntysUnavailable$740.32
BeaumontUnavailable$664.94
BrazoriaUnavailable$681.33

27356 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27356 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27356 rate is calculated

Each of 27356’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 · 27356

RVUs × geographic indexes × conversion factor

Work9.84

9.84 RVUs× 1.000 GPCI

Practice expense8.93

8.93 RVUs× 1.000 GPCI

Malpractice2.09

2.09 RVUs× 1.000 GPCI

Adjusted RVUs

20.8600

Conversion factor

$33.4009

Medicare rate

$696.74

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

Payment rules and modifiers for 27356

27356 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27356

Bone lesion surgery

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 · 27356

Bone lesion surgery

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

27356 without 50 · national facility

$696.74

Bone lesion surgery

27356-50 · Bilateral: 150%

$1,045.11

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

27356 compared with similar codes

Compare codes · National

4 codes, side by side

  • 27356

    Bone lesion surgery9.84 wRVU

    Not priced

  • 27355

    Femur lesion removal7.8 wRVU

    Not priced

  • 27357

    Femur lesion removal10.88 wRVU

    Not priced

  • 27358

    Femur lesion4.61 wRVU

    Not priced

How to choose

27355Femur lesion removal
Choose 27355 when the lesion is treated without graft; 27356 includes filling the defect with autograft.
27357Femur lesion removal
Choose 27357 for allograft. Code 27356 is the corresponding grafted treatment using the patient’s own bone.
27358Femur lesion
Choose 27358 when internal fixation is part of the femoral lesion treatment; 27356 identifies treatment with autograft.

Codes related to 27356

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

Codes related to 27356
CodeHow it relatesNational office range
Same family
27355Femur lesion removalFemoral lesion curettage or excision without graft.No office rate
27357Femur lesion removalFemoral lesion curettage or excision with allograft.No office rate
27358Femur lesionFemoral lesion treatment involving internal fixation.No office rate

27356 billing questions

How does this differ from 27355?

Use 27356 when the femoral lesion is curetted or excised and the defect is filled with autograft. Code 27355 describes the corresponding treatment without graft.

Does this code include harvesting the bone graft?

Yes. The autograft procurement is included; do not separately report the graft-harvesting work.

When is 27357 a better choice?

Use 27357 when the graft placed in the defect is allograft rather than the patient’s own bone.

How should bilateral femoral lesions be reported?

Report bilateral treatment with modifier 50. CMS pays the bilateral procedure at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. 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 27356PPRRVU2026_Oct_nonQPP.csv, line 2,854 (RVU26D)

Open CMS sourceHow we calculate rates

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