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Billing code 27626: Ankle synovectomyMedicare rate & RVUs

Reported for open removal of extensive abnormal synovial tissue from the ankle joint, such as in chronic proliferative or inflammatory synovitis.

CMS RVU26DEffective Oct 1, 2026109 payment localities320 Medicare services in 2024

Medicare pays $564.14 for 27626 nationally in a facility.

Medicare rate · 27626

Ankle synovectomy

Swap in your local Medicare rate.

Work RVUs
8.87
Total RVUs
16.89
Global days
090

National rate · 2026

$564.14

Facility setting, before claim adjustments.

See every locality for 27626 → · 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 27626 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 27626 covers

An orthopedic surgeon uses an open approach to remove extensive diseased synovial tissue from the ankle joint. This may be performed for persistent proliferative synovitis, including synovitis associated with inflammatory arthritis, when the surgeon determines that a broad synovectomy is needed. The arthrotomy provides access to the joint; tissue sampling performed as part of the procedure is included in the service. This is an open operation, distinct from arthroscopic synovectomy.

Choose this code when the operative report supports an extensive synovectomy, rather than the less extensive procedure represented by 27625. Document the affected ankle, the approach, the distribution and extent of abnormal synovium removed, and the reason for surgery. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same 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; 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 27626 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

27626 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$516.93
Alaska*Unavailable$706.85
ArizonaUnavailable$550.82
ArkansasUnavailable$511.09
AtlantaUnavailable$577.53
AustinUnavailable$572.63
BakersfieldUnavailable$573.85
Baltimore/Surr. CntysUnavailable$595.72
BeaumontUnavailable$540.88
BrazoriaUnavailable$554.73

27626 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
27626 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 27626 rate is calculated

Each of 27626’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 · 27626

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.87Practice expense 6.69Malpractice 1.33

16.8900 adjusted RVUs×$33.4009 conversion factor=$564.14

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

Payment rules and modifiers for 27626

27626 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27626

Ankle synovectomy

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)0Not permitted.
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 · 27626

Ankle synovectomy

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

27626 without 50 · national facility

$564.14

Ankle synovectomy

27626-50 · Bilateral: 150%

$846.21

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

27626 compared with similar codes

Compare codes

27626 vs 27625 vs 27620: national Medicare rates

Swap in your local Medicare rate.

  • 27626
    Ankle synovectomy · 8.87 wRVU
    —
  • 27625
    Ankle synovectomy · 8.28 wRVU
    —
  • 27620
    Ankle arthrotomy · 6 wRVU
    —

How to choose

27625Ankle synovectomy
Both describe open ankle synovectomy through arthrotomy. Select 27626 when the documentation supports extensive removal; 27625 represents the less extensive procedure.
27620Ankle arthrotomy
This code is for extensive synovectomy. Use 27620 when the open ankle-joint work is exploration or another covered treatment without the extensive synovectomy.

Codes related to 27626

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

Codes related to 27626
CodeHow it relatesNational office range
Same family
27625Ankle synovectomyOpen ankle synovectomy for a less extensive removal of synovial tissue.No office rate
Used instead
27620Ankle arthrotomyOpen ankle-joint exploration or treatment without the extensive synovectomy represented here.No office rate
29895Ankle arthroscopyArthroscopic ankle synovectomy when the work is partial rather than extensive.No office rate

27626 billing questions

How do I distinguish 27626 from 27625?

Use 27626 when the operative documentation supports an extensive ankle synovectomy. Use 27625 for the less extensive open synovectomy.

Can the biopsy performed during the arthrotomy be billed separately?

Biopsy performed as part of this ankle synovectomy is included in the service. The operative note should describe the synovium removed and any tissue submitted for examination.

Can 27626 be reported for an arthroscopic synovectomy?

No. This code describes an open synovectomy through arthrotomy; arthroscopic ankle synovectomy codes distinguish partial from major synovectomy.

What modifiers and payment rules should I check?

Modifier 50 applies to bilateral reporting, which CMS pays at 150%. The procedure has a 90-day global period, and same-session multiple procedures are subject to the standard reduction.

May an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.

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 27626PPRRVU2026_Oct_nonQPP.csv, line 2,980 (RVU26D)

Open CMS sourceHow we calculate rates

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