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Billing code 27637: Bone lesion graftingMedicare rate & RVUs

Reports curettage or excision of a benign tibial or fibular bone lesion when the resulting cavity is filled with donor bone graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities270 Medicare services in 2024

Medicare pays $707.77 for 27637 nationally in a facility.

Medicare rate · 27637

Bone lesion grafting

Swap in your local Medicare rate.

Work RVUs
10.05
Total RVUs
21.19
Global days
090

National rate · 2026

$707.77

Facility setting, before claim adjustments.

See every locality for 27637 → · 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 27637 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 27637 covers

This operation treats a cyst or benign tumor in the tibia or fibula by opening the involved bone, removing or scraping out the lesion, and filling the resulting defect with donor bone (allograft). Orthopedic surgeons typically perform it in an operating room when curettage leaves a cavity to be grafted. The operative record should identify the bone and side, lesion, removal technique, and use of allograft.

Choose this code when the lesion is treated by curettage or excision with allograft; 27635 describes the corresponding procedure without graft, while 27638 is used when autograft is used. The 90-day global period includes 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 may be available; co-surgeon payment requires supporting documentation, and 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 27637 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

27637 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$640.61
Alaska*Unavailable$865.45
ArizonaUnavailable$688.68
ArkansasUnavailable$632.32
AtlantaUnavailable$727.08
AustinUnavailable$718.53
BakersfieldUnavailable$717.33
Baltimore/Surr. CntysUnavailable$751.25
BeaumontUnavailable$675.55
BrazoriaUnavailable$693.01

27637 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
27637 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 27637 rate is calculated

Each of 27637’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 · 27637

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.05Practice expense 9.14Malpractice 2.00

21.1900 adjusted RVUs×$33.4009 conversion factor=$707.77

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

Payment rules and modifiers for 27637

27637 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27637

Bone lesion grafting

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)1Permitted with supporting documentation.
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 · 27637

Bone lesion grafting

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

27637 without 50 · national facility

$707.77

Bone lesion grafting

27637-50 · Bilateral: 150%

$1,061.66

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

27637 compared with similar codes

Compare codes

27637 vs 27635 vs 27638 vs 27645 vs 27646: national Medicare rates

Swap in your local Medicare rate.

  • 27637
    Bone lesion grafting · 10.05 wRVU
    —
  • 27635
    Bone lesion removal · 7.83 wRVU
    —
  • 27638
    Bone lesion surgery · 10.72 wRVU
    —
  • 27645
    Tibial tumor resection · 26.53 wRVU
    —
  • 27646
    Bone tumor resection · 22.63 wRVU
    —

How to choose

27635Bone lesion removal
Use 27637 when allograft fills the cavity after lesion removal; 27635 is the corresponding procedure without graft.
27638Bone lesion surgery
Both codes cover curettage or excision of a tibial or fibular bone lesion with grafting. Choose 27638 when the graft is autograft rather than allograft.
27645Tibial tumor resection
27645 describes resection of a tibial tumor. 27637 is for curettage or excision of a benign lesion with allograft.
27646Bone tumor resection
27646 describes resection of a fibular tumor. 27637 is for curettage or excision of a benign lesion with allograft.

Codes related to 27637

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

Codes related to 27637
CodeHow it relatesNational office range
Same family
27635Bone lesion removalCurettage or excision of a tibial or fibular bone lesion without graft.No office rate
27638Bone lesion surgeryThe corresponding lesion procedure uses autograft rather than allograft.No office rate
Used instead
27645Tibial tumor resectionTibial tumor resection is a different approach from curettage with allograft.No office rate
27646Bone tumor resectionFibular tumor resection is a different approach from curettage with allograft.No office rate

27637 billing questions

How does 27637 differ from 27635?

27637 includes filling the lesion cavity with allograft. Use 27635 for the corresponding curettage or excision without graft.

How does 27637 differ from 27638?

The graft source distinguishes them: 27637 is for allograft, while 27638 is for autograft, including obtaining the graft.

Is the allograft placement part of this code?

Yes. The code describes treatment of the tibial or fibular lesion with allograft; do not separately report 27635 for the same lesion removal.

What should the operative note support?

Document the lesion, affected bone and side, curettage or excision, and use of allograft to fill the defect.

How is bilateral reporting handled?

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

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 27637PPRRVU2026_Oct_nonQPP.csv, line 2,985 (RVU26D)

Open CMS sourceHow we calculate rates

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