No office rate
Use 27635 for tibial or fibular cyst or benign-tumor removal without the grafting represented by 27637; the graft-specific procedure belongs to 27637.
On this page
CMS RVU26D · Effective 2026-10-01
27635 Bone lesion removal Medicare reimbursement rates
Reported for operative excision or curettage of a cyst or benign tumor in the tibia or fibula when the procedure does not include bone grafting. Compare 27635 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27635?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 27635 pays more and less
Orthopedic surgery
About 27635: Curettage of tibial or fibular bone lesion
Reported for operative excision or curettage of a cyst or benign tumor in the tibia or fibula when the procedure does not include bone grafting.
An orthopedic surgeon or orthopedic oncologist uses this procedure to remove or curette a bone cyst or benign tumor in the tibia or fibula. The surgeon exposes the affected bone and removes the lesion, typically in an operating room. The removed tissue may be submitted for pathology. The code distinguishes this treatment of a lower-leg bone lesion from removal of a soft-tissue mass or a more extensive bone resection.
Select this code when the documented procedure treats a tibial or fibular cyst or benign tumor without the grafting described by the related graft-specific codes. The operative report should identify the bone and lesion, describe the excision or curettage, and document whether a graft was used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27635
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.83 · 48%
- Practice expense (office) RVU7.12 · 44%
- Malpractice RVU1.39 · 9%
1.1K
Medicare services in 2024 · #2927 by national volume
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.
27635 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
27638 is the related graft-specific option for allografting. 27635 describes lesion removal or curettage without that grafting.
No office rate
27640 describes partial removal of the tibia, rather than curettage or excision of a cyst or benign tumor.
No office rate
27645 is for tibial tumor resection; 27635 describes excision or curettage of a bone cyst or benign tumor.
See how rates vary across the country
27635 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 27635 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $495.89 |
| Alaska* | Office Unavailable | Facility $671.15 |
| Arizona | Office Unavailable | Facility $531.71 |
| Arkansas | Office Unavailable | Facility $489.72 |
| Atlanta | Office Unavailable | Facility $559.69 |
| Austin | Office Unavailable | Facility $554.79 |
| Bakersfield | Office Unavailable | Facility $555.42 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $578.32 |
| Beaumont | Office Unavailable | Facility $521.07 |
| Brazoria | Office Unavailable | Facility $535.51 |
| Chicago | Office Unavailable | Facility $608.91 |
| Chico | Office Unavailable | Facility $551.50 |
| Colorado | Office Unavailable | Facility $553.96 |
| Connecticut | Office Unavailable | Facility $579.06 |
| Dallas | Office Unavailable | Facility $540.58 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $607.47 |
| Delaware | Office Unavailable | Facility $539.54 |
| Detroit | Office Unavailable | Facility $569.30 |
| East St. Louis | Office Unavailable | Facility $573.82 |
| El Centro | Office Unavailable | Facility $551.74 |
| Fort Lauderdale | Office Unavailable | Facility $586.38 |
| Fort Worth | Office Unavailable | Facility $538.81 |
| Fresno | Office Unavailable | Facility $551.50 |
| Galveston | Office Unavailable | Facility $538.21 |
| Hanford-Corcoran | Office Unavailable | Facility $551.50 |
| Hawaii, Guam | Office Unavailable | Facility $558.81 |
| Houston | Office Unavailable | Facility $563.65 |
| Idaho | Office Unavailable | Facility $502.28 |
| Indiana | Office Unavailable | Facility $504.55 |
| Iowa | Office Unavailable | Facility $497.56 |
| Kansas | Office Unavailable | Facility $499.91 |
| Kentucky | Office Unavailable | Facility $515.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $584.41 |
| Madera | Office Unavailable | Facility $551.50 |
| Manhattan | Office Unavailable | Facility $628.24 |
| Merced | Office Unavailable | Facility $551.50 |
| Metropolitan Boston | Office Unavailable | Facility $597.52 |
| Metropolitan Kansas City | Office Unavailable | Facility $530.20 |
| Metropolitan Philadelphia | Office Unavailable | Facility $569.19 |
| Metropolitan St. Louis | Office Unavailable | Facility $534.45 |
| Miami | Office Unavailable | Facility $626.51 |
| Minnesota | Office Unavailable | Facility $519.98 |
| Mississippi | Office Unavailable | Facility $500.60 |
| Modesto | Office Unavailable | Facility $551.50 |
| Montana** | Office Unavailable | Facility $545.68 |
| Napa | Office Unavailable | Facility $615.03 |
| Nebraska | Office Unavailable | Facility $498.58 |
| Nevada** | Office Unavailable | Facility $538.26 |
| New Hampshire | Office Unavailable | Facility $549.72 |
| New Mexico | Office Unavailable | Facility $535.36 |
| New Orleans | Office Unavailable | Facility $538.05 |
| North Carolina | Office Unavailable | Facility $513.08 |
| North Dakota** | Office Unavailable | Facility $518.19 |
| Northern Nj | Office Unavailable | Facility $603.45 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $647.24 |
| Ohio | Office Unavailable | Facility $525.45 |
| Oklahoma | Office Unavailable | Facility $509.97 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $578.87 |
| Portland | Office Unavailable | Facility $564.47 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $589.88 |
| Puerto Rico | Office Unavailable | Facility $547.69 |
| Queens | Office Unavailable | Facility $626.31 |
| Redding | Office Unavailable | Facility $551.50 |
| Rest Of California | Office Unavailable | Facility $551.50 |
| Rest Of Florida | Office Unavailable | Facility $558.66 |
| Rest Of Georgia | Office Unavailable | Facility $529.00 |
| Rest Of Illinois | Office Unavailable | Facility $551.22 |
| Rest Of Louisiana | Office Unavailable | Facility $516.47 |
| Rest Of Maine | Office Unavailable | Facility $509.20 |
| Rest Of Maryland | Office Unavailable | Facility $547.43 |
| Rest Of Massachusetts | Office Unavailable | Facility $553.13 |
| Rest Of Michigan | Office Unavailable | Facility $531.07 |
| Rest Of Missouri | Office Unavailable | Facility $511.75 |
| Rest Of New Jersey | Office Unavailable | Facility $582.61 |
| Rest Of New York | Office Unavailable | Facility $520.09 |
| Rest Of Oregon | Office Unavailable | Facility $531.03 |
| Rest Of Pennsylvania | Office Unavailable | Facility $523.72 |
| Rest Of Texas | Office Unavailable | Facility $529.14 |
| Rest Of Washington | Office Unavailable | Facility $550.68 |
| Rhode Island | Office Unavailable | Facility $553.57 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $566.48 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $572.41 |
| Salinas | Office Unavailable | Facility $570.15 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $578.96 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $643.00 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $641.42 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $658.11 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $651.66 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $561.73 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $580.85 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $571.03 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $586.30 |
| Seattle (King Cnty) | Office Unavailable | Facility $604.33 |
| South Carolina | Office Unavailable | Facility $520.73 |
| South Dakota** | Office Unavailable | Facility $514.94 |
| Southern Maine | Office Unavailable | Facility $526.50 |
| Stockton | Office Unavailable | Facility $551.50 |
| Suburban Chicago | Office Unavailable | Facility $589.86 |
| Tennessee | Office Unavailable | Facility $502.63 |
| Utah | Office Unavailable | Facility $526.77 |
| Vallejo | Office Unavailable | Facility $612.75 |
| Vermont | Office Unavailable | Facility $520.46 |
| Virgin Islands | Office Unavailable | Facility $547.69 |
| Virginia | Office Unavailable | Facility $528.08 |
| Visalia | Office Unavailable | Facility $551.50 |
| West Virginia | Office Unavailable | Facility $534.63 |
| Wisconsin | Office Unavailable | Facility $503.65 |
| Wyoming** | Office Unavailable | Facility $533.70 |
| Yuba City | Office Unavailable | Facility $551.50 |
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27635 billing questions
How does this differ from 27637 or 27638?
27635 is for tibial or fibular lesion removal without the grafting represented by those related codes. Choose the applicable graft-specific code when the operative service includes that grafting.
Can I report this for a biopsy alone?
No. A diagnostic biopsy that samples lower-leg soft tissue is a different service; 27635 describes operative removal or curettage of a bone cyst or benign tumor.
What should the operative note support?
Document whether the lesion was in the tibia or fibula, its cystic or benign-tumor diagnosis, the removal or curettage performed, and whether grafting was part of the procedure.
How is bilateral treatment reported?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support treatment of both sides.
Does the surgeon's postoperative care fall within the global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is subject to a statutory restriction and is not paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,98127630,,Removal of tendon lesion,A,,4.82,11.44,,4.84,,0.72,16.98,10.38,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98227632,,Exc leg/ankle les sc 3 cm/>,A,,5.76,4.79,NA,4.79,,1.22,11.77,11.77,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98327634,,Exc leg/ankle tum dep 5 cm/>,A,,9.88,6.86,NA,6.86,,1.92,18.66,18.66,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98427635,,Remove lower leg bone lesion,A,,7.83,7.12,NA,7.12,,1.39,16.34,16.34,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98527637,,Remove/graft leg bone lesion,A,,10.05,9.14,NA,9.14,,2.00,21.19,21.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98627638,,Remove/graft leg bone lesion,A,,10.72,8.26,NA,8.26,,1.94,20.92,20.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98727640,,Partial removal of tibia,A,,11.93,8.90,NA,8.90,,2.18,23.01,23.01,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00