Billing code 27497: Compartment decompressionMedicare rate & RVUs

Medicare pays $551.78 for 27497 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27497 covers

This code covers operative decompression of a compartment in the thigh or around the knee. It is most relevant when elevated compartment pressure requires surgical release, such as in an acute limb-threatening presentation after trauma or surgery. An orthopedic surgeon or another surgeon qualified to perform the procedure typically provides the service in a hospital operating room. The operative report should identify the treated site and describe the decompression performed.

Select this code from the documented procedure and the full billing code descriptor, distinguishing it from nearby decompression entries rather than relying on the CMS short descriptor alone. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, while 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 27497 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

27497 rates by state

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

How the 27497 rate is calculated

Each of 27497’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.

Payment rules and modifiers for 27497

27497 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27497 compared with similar codes

How to choose

27496Thigh fasciotomy

Both are nearby thigh or knee decompression entries. Use the full billing code descriptors and operative details to identify the procedure performed; the short descriptors alone do not distinguish them.

27498Fasciotomy

This is another nearby decompression entry. Select between the codes by matching the documented site and operative work to each full descriptor.

27602Leg decompression

This code concerns decompression of lower-leg compartments. Use it when the operative site is the lower leg rather than the thigh or knee.

27499Unlisted procedure

Use the unlisted femur or knee procedure code only when no listed code accurately describes the documented service.

Codes related to 27497

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

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

Open CMS sourceHow we calculate rates