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Billing code 27498: FasciotomyMedicare rate & RVUs

Reports operative decompression of the thigh or knee by releasing constricting fascia, such as for compartment pressure requiring surgical relief.

CMS RVU26DEffective Oct 1, 2026109 payment localities80 Medicare services in 2024

Medicare pays $624.93 for 27498 nationally in a facility.

Medicare rate · 27498

Fasciotomy

Swap in your local Medicare rate.

Work RVUs
8.44
Total RVUs
18.71
Global days
090

National rate · 2026

$624.93

Facility setting, before claim adjustments.

See every locality for 27498 → · 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 27498 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 27498 covers

A surgeon releases constricting fascia in the thigh or around the knee to relieve pressure within the affected area. This type of operation may be performed for acute compartment syndrome, including after trauma or another operation, in a hospital or other surgical facility. The operative report should identify the treated anatomy, the decompression performed, and the clinical reason for relieving pressure.

Report 27498 when the documented thigh or knee procedure matches this code’s specific service, rather than selecting a neighboring code from the brief descriptor alone. The record should make the treated site and operative work clear enough to distinguish this service from other compartment-decompression options. Medicare treats it as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid, and co-surgeons are permitted; 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 27498 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

27498 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$563.58
Alaska*Unavailable$757.45
ArizonaUnavailable$607.54
ArkansasUnavailable$556.00
AtlantaUnavailable$642.33
AustinUnavailable$635.11
BakersfieldUnavailable$634.10
Baltimore/Surr. CntysUnavailable$664.29
BeaumontUnavailable$595.19
BrazoriaUnavailable$611.48

27498 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
27498 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 27498 rate is calculated

Each of 27498’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 · 27498

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.44Practice expense 8.48Malpractice 1.79

18.7100 adjusted RVUs×$33.4009 conversion factor=$624.93

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

Payment rules and modifiers for 27498

27498 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27498

Fasciotomy

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)2Permitted.
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 · 27498

Fasciotomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

27498 without 50 · national facility

$624.93

Fasciotomy

27498-50 · Bilateral: 150%

$937.39

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

27498 compared with similar codes

Compare codes

27498 vs 27496 vs 27497 vs 27499 vs 27602: national Medicare rates

Swap in your local Medicare rate.

  • 27498
    Fasciotomy · 8.44 wRVU
    —
  • 27496
    Thigh fasciotomy · 6.61 wRVU
    —
  • 27497
    Compartment decompression · 7.6 wRVU
    —
  • 27499
    Unlisted procedure · 9.19 wRVU
    —
  • 27602
    Leg decompression · 7.62 wRVU
    —

How to choose

27496Thigh fasciotomy
Both codes describe thigh/knee decompression services. Use the full descriptors and operative documentation to identify which specific service was performed.
27497Compartment decompression
This is another code in the thigh/knee decompression family. The operative details, not the shared short descriptor, determine the appropriate family member.
27499Unlisted procedure
27498 is a listed thigh/knee decompression code; 27499 is the unlisted femur or knee option when no listed procedure code fits.
27602Leg decompression
27602 concerns decompression of leg compartments. 27498 concerns the thigh or knee region.

Codes related to 27498

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

Codes related to 27498
CodeHow it relatesNational office range
Same family
27496Thigh fasciotomyNeighboring thigh/knee decompression option; select according to its full descriptor and the operative details.No office rate
27497Compartment decompressionAnother thigh/knee decompression option distinguished by its full code descriptor.No office rate
Used instead
27499Unlisted procedureUnlisted femur or knee procedure code when no listed code describes the documented operation.No office rate
27602Leg decompressionCompartment decompression option for the leg rather than the thigh or knee.No office rate

27498 billing questions

How should 27498 be distinguished from 27496 or 27497?

All are in the thigh/knee decompression family. Compare the specific service documented in the operative report with each code’s full descriptor; the short CMS label alone does not establish the distinction.

What documentation supports reporting 27498?

Document the thigh or knee anatomy treated, the operative decompression performed, and the clinical reason for relieving pressure. The operative details should support this code rather than another option in the decompression family.

Does the Medicare global period include postoperative care?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.

How does Medicare handle bilateral reporting?

When the procedure is performed bilaterally and reported with modifier 50, Medicare pays it at 150%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid, and co-surgeons are permitted. Team surgery is not permitted for this code.

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 27498PPRRVU2026_Oct_nonQPP.csv, line 2,920 (RVU26D)

Open CMS sourceHow we calculate rates

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