No office rate
Choose 27635 when the lesion is treated without grafting. This code represents treatment with donor allograft.
On this page
CMS RVU26D · Effective 2026-10-01
27638 Bone lesion surgery Medicare reimbursement rates in Delaware
Reports curettage or excision of a benign bone cyst or tumor in the tibia or fibula when the resulting cavity is filled with donor bone. Compare 27638 office and facility rates across CMS payment localities in Delaware.
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 27638 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$690.68
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Orthopedic surgery
About 27638: Lower leg bone lesion curettage with allograft
Reports curettage or excision of a benign bone cyst or tumor in the tibia or fibula when the resulting cavity is filled with donor bone.
An orthopedic surgeon, often an orthopedic oncologist, removes or curettes a benign bone cyst or tumor in the tibia or fibula and fills the resulting cavity with donor bone allograft. This approach may be used for a contained lesion when curettage is appropriate and grafting is part of the operative treatment. The service is generally performed in a hospital or ambulatory surgery setting.
Report this code when the operative record supports the lesion’s tibial or fibular location, removal or curettage, and placement of allograft. Distinguish it from the related codes for treatment without graft or with the patient’s own graft. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27638
- 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 RVU10.72 · 51%
- Practice expense (office) RVU8.26 · 39%
- Malpractice RVU1.94 · 9%
103
Medicare services in 2024 · #4856 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.
27638 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Choose 27637 when the cavity is filled with the patient’s own bone graft; this code is for donor allograft.
No office rate
27645 describes resection of a tibial tumor. This code is for curettage or excision of a benign lesion with allograft, not tumor resection.
No office rate
27646 describes resection of a fibular tumor. This code is for curettage or excision of a benign lesion with allograft, not tumor resection.
Compare 27638 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$690.68
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27638 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,986
- Code
- 27638
- Physician work
- 10.72
- Practice expense
- 8.26
- Malpractice
- 1.94
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.72 | × 1.005 | 10.7736 |
| Practice expense | 8.26 | × 0.988 | 8.1609 |
| Malpractice | 1.94 | × 0.899 | 1.7441 |
| Total RVUs | 20.6785 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$690.68
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.72 | 1.005 |
| Practice expense | 8.26 | 0.988 |
| Malpractice | 1.94 | 0.899 |
(10.72 × 1.005 + 8.26 × 0.988 + 1.94 × 0.899) × $33.4009 = $690.68
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27638 billing questions
How does this differ from 27637?
This code is for filling the treated tibial or fibular lesion cavity with donor allograft. Code 27637 is the related option when the surgeon uses autograft.
When is 27635 more appropriate?
Use 27635 for the corresponding lesion removal or curettage without bone grafting. The operative note should make clear whether graft was placed.
Does the code include the allograft placement?
Yes. The allograft is part of the coded lesion treatment; documentation should identify graft use and its placement in the cavity.
What documentation supports this code?
Document the tibia or fibula as the site, the benign cyst or tumor and its treatment by excision or curettage, and use of allograft.
How does the 90-day global period affect billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires 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.
2,98327634,,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
2,98927645,,Resect tibia tumor,A,,26.53,15.41,NA,15.41,,5.64,47.58,47.58,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503