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Billing code 27704: Ankle implant removalMedicare rate & RVUs

Reports operative removal of an ankle joint prosthetic implant, such as when a failed or infected ankle replacement is explanted.

CMS RVU26DEffective Oct 1, 2026109 payment localities237 Medicare services in 2024

Medicare pays $529.40 for 27704 nationally in a facility.

Medicare rate · 27704

Ankle implant removal

Swap in your local Medicare rate.

Work RVUs
7.61
Total RVUs
15.85
Global days
090

National rate · 2026

$529.40

Facility setting, before claim adjustments.

See every locality for 27704 → · 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 27704 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 27704 covers

27704 represents operative removal of a prosthetic implant from the ankle joint, such as explantation of components from a prior total ankle replacement. An orthopedic surgeon, often a foot-and-ankle specialist, may perform the procedure for a failed or infected implant. A staged explant for infection, with replacement planned for a later operation, is a typical clinical situation. This is distinct from removing fixation screws or plates from bone.

Report the code when the operative record supports removal of the ankle joint implant; document the indication and which components were removed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons require 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 27704 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

27704 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$481.48
Alaska*Unavailable$651.89
ArizonaUnavailable$515.93
ArkansasUnavailable$475.55
AtlantaUnavailable$542.67
AustinUnavailable$538.35
BakersfieldUnavailable$539.35
Baltimore/Surr. CntysUnavailable$560.74
BeaumontUnavailable$505.47
BrazoriaUnavailable$519.73

27704 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
27704 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 27704 rate is calculated

Each of 27704’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 · 27704

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.61Practice expense 6.93Malpractice 1.31

15.8500 adjusted RVUs×$33.4009 conversion factor=$529.40

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

Payment rules and modifiers for 27704

27704 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27704

Ankle implant removal

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)1Not paid (statutory restriction).
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 · 27704

Ankle implant removal

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

27704 without 50 · national facility

$529.40

Ankle implant removal

27704-50 · Bilateral: 150%

$794.10

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

27704 compared with similar codes

Compare codes

27704 vs 20680 vs 27703 vs 27702: national Medicare rates

Swap in your local Medicare rate.

  • 27704
    Ankle implant removal · 7.61 wRVU
    —
  • 20680
    Implant removal · 5.81 wRVU
    $631.95
  • 27703
    Ankle revision · 16.52 wRVU
    —
  • 27702
    Ankle replacement · 14.06 wRVU
    —

How to choose

20680Implant removal
Choose 27704 for removal of an ankle joint prosthesis. Use 20680 for deep fixation hardware, such as screws or plates, when that is the material being removed.
27703Ankle revision
27704 describes removal of the ankle implant. 27703 is considered when the procedure revises the total ankle replacement rather than removing the implant alone.
27702Ankle replacement
27702 describes an ankle replacement procedure with an implant; 27704 is for removing a previously implanted ankle prosthesis.

Codes related to 27704

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

Codes related to 27704
CodeHow it relatesNational office range
Used instead
20680Implant removalUsed for deep fixation hardware removal, not removal of an ankle joint prosthetic implant.$558.02–$814.76
27703Ankle revisionFor revision of a total ankle replacement rather than removal alone.No office rate
27702Ankle replacementFor ankle replacement with an implant, not explantation of an existing implant.No office rate

27704 billing questions

How is 27704 different from 20680?

27704 is for removal of an ankle joint prosthetic implant. 20680 is generally used for removal of deep fixation hardware, such as screws or plates, rather than an ankle joint replacement.

Should 27704 be reported when an ankle replacement is revised?

When the operation revises the ankle replacement, consider the revision service, such as 27703, rather than treating implant removal as the only service. The operative work and applicable coding edits determine whether removal is separately reportable.

What documentation supports 27704?

Document the reason for explantation, the ankle implant being removed, and the components taken out. For a staged procedure, the record should distinguish the removal operation from any later reconstruction.

How does Medicare handle bilateral reporting?

For bilateral ankle implant removal reported with modifier 50, CMS pays 150% under the stated bilateral rule.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided; 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 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 27704PPRRVU2026_Oct_nonQPP.csv, line 3,017 (RVU26D)

Open CMS sourceHow we calculate rates

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