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Billing code 27358: Femur lesionMedicare rate & RVUs

Add-on reporting for internal fixation performed with curettage or excision of a femoral bone lesion when stabilization is part of treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $236.48 for 27358 nationally in a facility.

Medicare rate · 27358

Femur lesion

Swap in your local Medicare rate.

Work RVUs
4.61
Total RVUs
7.08
Global days
ZZZ

National rate · 2026

$236.48

Facility setting, before claim adjustments.

See every locality for 27358 → · 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 27358 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 27358 covers

This add-on captures internal fixation performed with operative treatment of a femoral bone lesion, such as curettage or excision of a benign lesion when the bone needs stabilization. An orthopedic surgeon typically performs the work in an operating room, placing fixation as part of the same operative treatment. The fixation supports the treated segment; this code is not a stand-alone report for fixation unrelated to femoral lesion removal.

Report 27358 with the applicable primary femoral lesion procedure, such as 27355, when the operative record supports both lesion treatment and internal fixation. Documentation should identify the femoral lesion, describe the curettage or excision, and establish that fixation was performed as part of the treatment. CMS classifies the code as an add-on: it must be billed with a primary procedure, and payment falls within that procedure’s global period.

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 27358 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

27358 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$215.84
Alaska*Unavailable$301.66
ArizonaUnavailable$230.15
ArkansasUnavailable$213.36
AtlantaUnavailable$244.44
AustinUnavailable$235.83
BakersfieldUnavailable$231.06
Baltimore/Surr. CntysUnavailable$250.44
BeaumontUnavailable$229.69
BrazoriaUnavailable$229.92

27358 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
27358 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 27358 rate is calculated

Each of 27358’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 · 27358

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.61Practice expense 1.47Malpractice 1.00

7.0800 adjusted RVUs×$33.4009 conversion factor=$236.48

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27358

The CMS indicators that decide how 27358 is paid alongside other services.

CMS payment indicators · 27358

Femur lesion

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

27358 without 80 · national facility

$236.48

Femur lesion

27358-80 · Assistant: 16%

$37.84

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

27358 compared with similar codes

Compare codes

27358 vs 27355 vs 27356 vs 27365: national Medicare rates

Swap in your local Medicare rate.

  • 27358
    Femur lesion · 4.61 wRVU
    —
  • 27355
    Femur lesion removal · 7.8 wRVU
    —
  • 27356
    Bone lesion surgery · 9.84 wRVU
    —
  • 27365
    Bone tumor resection · 31.4 wRVU
    —

How to choose

27355Femur lesion removal
27355 reports the primary femoral lesion treatment. Add 27358 only when internal fixation is also performed as part of that treatment.
27356Bone lesion surgery
27356 is a related femoral lesion procedure variant involving grafting; 27358 captures fixation as an add-on to the primary procedure.
27365Bone tumor resection
27365 describes resection of a femoral or knee tumor. 27358 is for fixation accompanying the applicable femoral lesion procedure, not tumor resection by itself.

Codes related to 27358

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

Codes related to 27358
CodeHow it relatesNational office range
Add-on codes
27355Femur lesion removalPrimary femoral lesion procedure that may be reported with this fixation add-on.No office rate
Same family
27356Bone lesion surgeryRelated femoral lesion procedure variant involving grafting.No office rate
27357Femur lesion removalRelated femoral lesion procedure variant involving grafting.No office rate
Used instead
27365Bone tumor resectionUsed for femoral or knee tumor resection rather than the lesion-treatment and fixation combination.No office rate

27358 billing questions

Can 27358 be billed by itself?

No. It is an add-on code and must be reported with the applicable primary procedure for femoral lesion treatment.

When is 27358 appropriate with 27355?

Report it when the femoral lesion procedure includes internal fixation. The operative note should support both lesion treatment and fixation.

Does lesion removal alone support 27358?

No. The add-on represents fixation performed with the lesion procedure; lesion removal without fixation does not support it.

What documentation supports the fixation add-on?

Document the femoral lesion procedure and the internal fixation performed as part of that treatment. The code is paid within the primary procedure’s global period.

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 27358PPRRVU2026_Oct_nonQPP.csv, line 2,856 (RVU26D)

Open CMS sourceHow we calculate rates

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