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Billing code 27357: Femur lesion removalMedicare rate & RVUs

Orthopedic surgeons report this procedure when they curette or excise a femoral bone lesion and fill the resulting defect with allograft.

CMS RVU26DEffective Oct 1, 2026109 payment localities223 Medicare services in 2024

Medicare pays $766.55 for 27357 nationally in a facility.

Medicare rate · 27357

Femur lesion removal

Work RVUs
10.88
Total RVUs
22.95
Global days
090

National rate · 2026

$766.55

Facility setting, before claim adjustments.

See every locality for 27357 →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 27357 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 27357 covers

An orthopedic surgeon treats a cyst or benign tumor within the femur by removing the lesion through curettage or excision, then filling the bone defect with allograft. The operation is generally performed in a hospital operating room, often when imaging and clinical evaluation support treatment of a lesion that can be managed without wide tumor resection. The allograft distinguishes this service from similar femoral lesion procedures using no graft, autograft, or internal fixation.

Select the code when the operative report supports femoral lesion removal and use of allograft; document the lesion location, removal technique, and graft used. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for bilateral surgery is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 27357 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

27357 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$692.32
Alaska*Unavailable$934.80
ArizonaUnavailable$745.33
ArkansasUnavailable$683.16
AtlantaUnavailable$788.37
AustinUnavailable$777.39
BakersfieldUnavailable$774.58
Baltimore/Surr. CntysUnavailable$814.45
BeaumontUnavailable$731.73
BrazoriaUnavailable$749.55

27357 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
27357 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 27357 rate is calculated

Each of 27357’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 · 27357

RVUs × geographic indexes × conversion factor

Work10.88

10.88 RVUs× 1.000 GPCI

Practice expense9.76

9.76 RVUs× 1.000 GPCI

Malpractice2.31

2.31 RVUs× 1.000 GPCI

Adjusted RVUs

22.9500

Conversion factor

$33.4009

Medicare rate

$766.55

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

Payment rules and modifiers for 27357

27357 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27357

Femur lesion removal

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 · 27357

Femur lesion removal

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

27357 without 50 · national facility

$766.55

Femur lesion removal

27357-50 · Bilateral: 150%

$1,149.83

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

27357 compared with similar codes

Compare codes · National

5 codes, side by side

  • 27357

    Femur lesion removal10.88 wRVU

    Not priced

  • 27355

    Femur lesion removal7.8 wRVU

    Not priced

  • 27356

    Bone lesion surgery9.84 wRVU

    Not priced

  • 27358

    Femur lesion4.61 wRVU

    Not priced

  • 27365

    Bone tumor resection31.4 wRVU

    Not priced

How to choose

27355Femur lesion removal
Choose 27357 when allograft is used to fill the defect after femoral lesion removal. Code 27355 represents the corresponding procedure without grafting.
27356Bone lesion surgery
Choose 27356 for the autograft option. Code 27357 identifies use of allograft.
27358Femur lesion
Choose 27358 when internal fixation is part of the femoral lesion procedure. Code 27357 is distinguished by allograft use.
27365Bone tumor resection
This code is for curettage or excision of a femoral lesion with allograft. Code 27365 is the alternative for resection of a femoral or knee tumor.

Codes related to 27357

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

Codes related to 27357
CodeHow it relatesNational office range
Same family
27355Femur lesion removalFemoral lesion curettage or excision without grafting.No office rate
27356Bone lesion surgeryFemoral lesion procedure using autograft rather than allograft.No office rate
27358Femur lesionFemoral lesion procedure distinguished by internal fixation.No office rate
Used instead
27365Bone tumor resectionFemoral tumor resection when treatment involves tumor resection rather than this lesion curettage or excision service.No office rate

27357 billing questions

How does this differ from 27355 or 27356?

This code identifies femoral lesion curettage or excision with allograft. Code 27355 is the no-autograft option, while 27356 is the autograft option.

When would 27358 be more appropriate?

Use 27358 when the femoral lesion procedure includes internal fixation. The allograft procedure is distinguished by grafting rather than fixation.

What should the operative report document?

Document the femoral lesion, whether it was curetted or excised, and the use of allograft to fill the defect. Those details distinguish this service from neighboring femoral lesion codes.

Can the related postoperative visits be billed separately?

The 90-day global period includes related postoperative care for 90 days and the day-before preoperative visit. The global period applies to this major surgery.

How does Medicare handle bilateral reporting and multiple procedures?

Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and 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 27357PPRRVU2026_Oct_nonQPP.csv, line 2,855 (RVU26D)

Open CMS sourceHow we calculate rates

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