Billing code 27604: Bursa drainageMedicare rate & RVUs

Medicare pays $477.63 for 27604 nationally in the office and $316.64 in a hospital or facility. Local office rates run $421.96–$614.25.

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

What 27604 covers

An orthopedic or foot and ankle surgeon uses an incision to drain a bursa in the lower leg or ankle. The service is appropriate when the operative target is the bursa itself, rather than a separate soft-tissue lesion or the ankle joint. Documentation should identify the bursa and site, the reason open drainage was performed, and the operative work and findings.

Report this service for the bursal drainage, not for needle aspiration alone. The CMS global period is 90 days, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 27604 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

27604 rates by state

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

How the 27604 rate is calculated

Each of 27604’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 27604

27604 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

27604 compared with similar codes

How to choose

27603Deep drainage

27604 is for operative drainage of a lower-leg or ankle bursa. 27603 is for drainage of a lower-leg lesion, not specifically a bursa.

20605Joint procedure

20605 describes needle aspiration or injection of an intermediate joint or bursa. Use 27604 for open incision and drainage of a lower-leg or ankle bursa.

20610Joint injection

20610 describes needle aspiration or injection of a major joint or bursa, not operative incision and drainage. The open bursal procedure is 27604.

27610Ankle arthrotomy

27610 involves exploration or treatment of the ankle joint. 27604 targets a bursa in the lower leg or ankle, not the joint space.

Codes related to 27604

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