No office rate
Use 27637 when allograft fills the cavity after lesion removal; 27635 is the corresponding procedure without graft.
On this page
CMS RVU26D · Effective 2026-10-01
27637 Bone lesion grafting Medicare reimbursement rates in California
Reports curettage or excision of a benign tibial or fibular bone lesion when the resulting cavity is filled with donor bone graft. Compare 27637 office and facility rates across CMS payment localities in California.
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 27637 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$711.78–$848.63
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $136.85 per service.
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 27637 pays more and less in California
Orthopedic surgery
About 27637: Tibial or fibular lesion curettage with allograft
Reports curettage or excision of a benign tibial or fibular bone lesion when the resulting cavity is filled with donor bone graft.
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.
CMS billing rules for 27637
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.05 · 47%
- Practice expense (office) RVU9.14 · 43%
- Malpractice RVU2.00 · 9%
270
Medicare services in 2024 · #4074 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.
27637 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
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.
No office rate
27645 describes resection of a tibial tumor. 27637 is for curettage or excision of a benign lesion with allograft.
No office rate
27646 describes resection of a fibular tumor. 27637 is for curettage or excision of a benign lesion with allograft.
Compare 27637 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $717.33 |
| Chico | Office Unavailable | Facility $711.78 |
| El Centro | Office Unavailable | Facility $712.12 |
| Fresno | Office Unavailable | Facility $711.78 |
| Hanford-Corcoran | Office Unavailable | Facility $711.78 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $754.95 |
| Madera | Office Unavailable | Facility $711.78 |
| Merced | Office Unavailable | Facility $711.78 |
| Modesto | Office Unavailable | Facility $711.78 |
| Napa | Office Unavailable | Facility $793.13 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $747.54 |
| Redding | Office Unavailable | Facility $711.78 |
| Rest Of California | Office Unavailable | Facility $711.78 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $733.29 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $738.61 |
| Salinas | Office Unavailable | Facility $735.72 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $747.08 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $828.68 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $826.41 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $848.63 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $839.34 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $724.91 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $749.45 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $736.85 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $756.44 |
| Stockton | Office Unavailable | Facility $711.78 |
| Vallejo | Office Unavailable | Facility $789.85 |
| Visalia | Office Unavailable | Facility $711.78 |
| Yuba City | Office Unavailable | Facility $711.78 |
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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 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.
2,98227632,,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
2,98827641,,Partial removal of fibula,A,,9.59,7.13,NA,7.13,,1.54,18.26,18.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00