Billing code 27645: Tibial tumor resectionMedicare rate & RVUs

Medicare pays $1,589.21 for 27645 nationally in a facility.

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

What 27645 covers

This code describes an extensive operation to remove a tumor involving the tibia, generally by taking out the tumor-bearing bone as part of an oncologic resection. Orthopedic oncologists typically perform it in a hospital operating room after imaging and biopsy have informed surgical planning. The removed tissue is submitted for pathologic examination. The approach and amount of bone removed depend on the tumor and the planned resection; the diagnosis alone does not determine code selection.

Select this code when the operative report supports radical tumor resection of the tibia, rather than limited curettage, lesion excision, or partial bone removal. Documentation should identify the tibial site, tumor, resection performed, and relevant specimen. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is paid at 150% for a bilateral procedure. 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 27645 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

27645 rates by state

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

How the 27645 rate is calculated

Each of 27645’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 27645

27645 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

27645 compared with similar codes

How to choose

27635Bone lesion removal

This code represents radical resection of a tibial tumor. Code 27635 is for removal of a lower-leg bone lesion by a different, generally more limited approach.

27640Tibial bone excision

Code 27640 describes partial excision of the tibia. Choose this code when the documented operation is radical tumor resection, rather than partial tibial removal.

27646Bone tumor resection

Both are radical tumor resections, but 27646 is for the fibula; this code is for the tibia.

27647Bone tumor resection

Code 27647 applies to tumor resection involving the talus or calcaneus, not the tibia.

Codes related to 27645

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